Studying Health Inequalities

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.

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.

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.

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.

'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.

How can research on the social determinants of health be translated into real life public health practice? Challenging the research-practice gap, this text shows readers from a range of professions how their practice can help to minimise health inequalities. The social model of health embraces individual lifestyles, social and community networks, socio-economic, political and cultural influences and the plethora of factors that can impact on public health, for instance, education, work, welfare benefits, environment, housing, health and social care. All of these can have a significant effect on people’s experiences of health and well-being, and are often unrecognised sources of health inequalities. This innovative textbook outlines and discusses key public health principles and the social model of health. Drawing on a range of case studies and the international literature, it looks at how public health research has been applied to policy and practice. The book discusses the transferability that these findings have had and their capacity to influence and provide evidence for practice. Health and Inequality covers a broad range of social determinants of health, encountered throughout the life-course, including: Pre-birth and early years Breastfeeding and teenage mothers Health inequalities for mothers and babies in prison Children in full time education Sexuality, relationships and sexual health of young people Early adulthood Welfare rights and health benefits Women, employment and well-being Adults in later life Practical and clearly structured, this text will be useful to a range of health and social care professionals involved in public health work, particularly those undertaking courses on public health, health promotion or the social determinants of health.