Health Inequality

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.

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.

At a time when social inequalities are increasing at an alarming rate, this new edition of Mel Bartley's popular book is a vital resource for understanding the extent of health inequalities and why they are proving to be persistent despite decades of growing knowledge and policies on the issue. As in the first edition, by examining influences of social class, income, culture and wealth as well as gender, ethnicity and other factors in identity, this accessible book provides a key to understanding the major theories and explanations of what lies behind inequality in health. Bartley re-situates the classic behavioural, psycho-social, and material approaches within a life-course perspective. Evaluating the evidence of health outcomes over time and at local and national levels, Bartley argues that individual social integration demands closer attention if health inequality is to be tackled effectively, revealing the important part that identity plays in relation to the chances of a long and healthy life. Health Inequality will be essential reading for students taking courses in the sociology of health and illness, social policy and welfare, health sciences, public health and epidemiology and all those interested in understanding the consequences of social inequality for health.

There is a growing recognition that existing theories on, and approaches to, health inequities are limited in their ability to capture how they are produced through changing, co-constituted, and intersecting effects of multiple forms of oppression. Intersectionality considers the interactions and combined impacts of social locations and structural processes on the creation and perpetuation of inequities. This volume brings together activists, scholars, and community-based researchers to apply interpretations of intersectionality to health and organizational governance cases. By addressing specific health issues, it demonstrates that inequities cannot be understood without the interrogation of power and diverse social locations and structures that shape lives and experiences of health.

'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.

Why can't politicians seem to make policies that will reduce social inequality, even when they acknowledge that inequality is harmful?

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.

This edited volume provides wide-ranging anaylses and reviews of the UK's experiences of health inequalities research and policy to date, and reflects on the lessons that have been learnt from these experiences, both within the UK and internationally