Health Inequalities

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Tackling Health Inequalities: Lessons from International Experiences provides a unique perspective on health inequalities in Canada and elsewhere. This exciting new volume brings together experiences from seven wealthy developed nations -- the United States, Australia, Britain and Northern Ireland, Canada, Finland, Norway, and Sweden -- to analyze their contrasting approaches to reducing avoidable health problems. Some nations are successfully responding to health inequalities, but Canada and the United States are not among them. Why is this, and what can we learn from other nations? Through a political economy lens, Tackling Health Inequalities considers how societal structures and institutions shape the distribution of economic, political, and social resources that affect health disparities amongst the population. The volume then goes on to examine how governing authorities come to either confront or ignore these health inequalities and the conditions that create them. Through these illustrations, it encourages governing authorities that are tackling health inequalities to continue their efforts and directs those that are not -- such as in Canada and elsewhere -- towards what must be done. This groundbreaking text shows the primary lessons from these international experiences: that citizens in Canada and elsewhere need to educate themselves about the importance of tackling health inequalities, and then build the political and social movements that will compel governmental authorities to take action. This volume will serve as a rich resource for professionals and general readers interested in health studies, nursing, social work, public policy, and political economy.

The need for informed analyses of health policy is now greater than ever. The twelve essays in this volume show that public debates routinely bypass complex ethical, sociocultural, historical, and political questions about how we should address ideals of justice and equality in health care. Integrating perspectives from the humanities, social sciences, medicine, and public health, this volume illuminates the relationships between justice and health inequalities to enrich debates. Understanding Health Inequalities and Justice explores three questions: How do scholars approach relations between health inequalities and ideals of justice? When do justice considerations inform solutions to health inequalities, and how do specific health inequalities affect perceptions of injustice? And how can diverse scholarly approaches contribute to better health policy? From addressing patient agency in an inequitable health care environment to examining how scholars of social justice and health care amass evidence, this volume promotes a richer understanding of health and justice and how to achieve both. The contributors are Judith C. Barker, Paula Braveman, Paul Brodwin, Jami Suki Chang, Debra DeBruin, Leslie A. Dubbin, Sarah Horton, Carla C. Keirns, J. Paul Kelleher, Nicholas B. King, Eva Feder Kittay, Joan Liaschenko, Anne Drapkin Lyerly, Mary Faith Marshall, Carolyn Moxley Rouse, Jennifer Prah Ruger, and Janet K. Shim.

Addressing the implications of current British public health policies on the equal delivery of health services, this book--part of the Evidence for Public Health Practice series--explicitly identifies inequalities in health service practices. It offers an applied approach to researching, understanding, and dealing with this issue. Drawing on complexity theory, the authors use case studies to illustrate the problems, to discuss them in real-life terms, and to illuminate their complexities for students and practitioners of public health, health promotion, and health policy.

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

Bridging information gaps on health inequities faced by vulnerable children, adolescents, and families in Canada, this book informs readers of the key tools to promote productive, fulfilling lives of people managing prevalent health challenges.

Addressing health inequalities is a key focus for health and social care organizations. This book explores how best frontline health workers in areas of deprivation can address these problems. Aimed at doctors and their wider multidisciplinary teams, this book provides key knowledge and practical advice on how to address the causes and consequences of health inequalities to achieve better outcomes for patients. Considering the psychological, financial and social aspects of well-being as well as health concerns, this book offers a concise but comprehensive overview of the key issues in health inequalities and, most importantly, how practically to address them. Key Features Comprehensively covers the breadth of subjects identified by RCGP’s work to formulate a curriculum for health inequalities The first book to address the urgent area of causes and consequences of health inequalities in clinical practice. Chapters are authored by expert practitioners with proven experience in each aspect of health care. Applied, practical focus, demonstrating approaches that will work and can be applied in ‘every’ situation of inequality. Provides evidence of how community based primary care can make a change.

'Punchily written ... He leaves the reader with a sense of the gross injustice of a world where health outcomes are so unevenly distributed' Times Literary Supplement 'Splendid and necessary' Henry Marsh, author of Do No Harm, New Statesman There are dramatic differences in health between countries and within countries. But this is not a simple matter of rich and poor. A poor man in Glasgow is rich compared to the average Indian, but the Glaswegian's life expectancy is 8 years shorter. The Indian is dying of infectious disease linked to his poverty; the Glaswegian of violent death, suicide, heart disease linked to a rich country's version of disadvantage. In all countries, people at relative social disadvantage suffer health disadvantage, dramatically so. Within countries, the higher the social status of individuals the better is their health. These health inequalities defy usual explanations. Conventional approaches to improving health have emphasised access to technical solutions – improved medical care, sanitation, and control of disease vectors; or behaviours – smoking, drinking – obesity, linked to diabetes, heart disease and cancer. These approaches only go so far. Creating the conditions for people to lead flourishing lives, and thus empowering individuals and communities, is key to reduction of health inequalities. In addition to the scale of material success, your position in the social hierarchy also directly affects your health, the higher you are on the social scale, the longer you will live and the better your health will be. As people change rank, so their health risk changes. What makes these health inequalities unjust is that evidence from round the world shows we know what to do to make them smaller. This new evidence is compelling. It has the potential to change radically the way we think about health, and indeed society.