Wednesday, May 4, 2011

[EQ] The hidden inequity in health care

The hidden inequity in health care

Barbara Starfield, MD, MPH - University Distinguished Professor

Department of Health Policy and Management - Johns Hopkins University

International Journal for Equity in Health April 2011, 10:15 doi:10.1186/1475-9276-10-15

 

Available online PDF [8p.] at: http://bit.ly/ma1rhG

 

“……Inequity is the presence of systematic and potentially remediable differences among population groups defined socially, economically, or geographically [1,2]. It is not the same as inequality, which is a much broader term, generally used in the human rights field to describe differences among individuals, some of which are not remediable (at least with current knowledge).

 

Some languages do not make a distinction between the two terms, which may lead to confusion and a need to clarify exact meaning in different contexts. Some people use the term “unfairness” to define inequity, but unfairness is not measurable and therefore not a useful term for policy or evaluation.

 

Inequity can be horizontal or vertical. Horizontal inequity indicates that people with the same needs do not have access to the same resources. Vertical inequity exists when people with greater needs are not provided with greater resources. In population surveys, similar use of services across population groups signifies inequity, because different population subgroups have different needs, some more than others. What is generally considered equity (equal use across population subgroups) is, in fact, inequity.

Most industrialized countries have achieved both horizontal and vertical equity in the use of primary care services, meaning that people with greater health needs receive more primary care services. Although some countries have achieved horizontal equity in use of specialist services, very few have achieved vertical equity because socially-deprived populations have less access to specialist services than their needs require….”

 

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]
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“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
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[EQ] The Urgency of Tackling Inequalities

The Urgency of Tackling Inequalities

Opening remarks by Angel GurrĂ­a, OECD Secretary-General, delivered at the High-Level Policy Forum on Tackling Inequalities

Paris, 2 May 2011

Website: http://bit.ly/lrSeZR

 

Growing income inequality in OECD countries: What drives it and how can policy tackle it?

Organisation for Economic Co-operation and Development (OECD) May 2011

Available online PDF [14p.] at: http://bit.ly/mgMh9b

 

“…..Which lessons for policies?

Reforming tax and benefit policies is the most direct and powerful instrument to increase redistributive effects. Large and persistent losses of low-income groups following recessions underline the importance of well-targeted income-support policies. Government transfers – both in cash and in-kind – have an important role to play to guarantee that low-income households do not fall further back in the income distribution.


At the other end of the income spectrum, the relative stability of higher incomes – and their longer-term trends – is important to bear in mind in planning reforms of redistribution policies more broadly. It may be necessary to review whether existing tax provisions are still optimal in light of equity considerations and current revenue requirements. This is especially the case where the share of overall tax burdens borne by high-income groups has declined over recent years (e.g., because of non-compliance, cuts in marginal income taxes or because tax expenditures mainly benefit high-income groups).


However, redistribution strategies based on government transfers and taxes alone would be neither effective nor financially sustainable. A key challenge for policy is to facilitate and encourage access to employment for under-represented groups. This requires not only new jobs, but jobs that enable people to avoid and escape poverty. Recent trends towards higher rates of in-work poverty indicate that job quality has become a concern for a growing number of workers. Policy reforms that tackle inequalities in the labour market, such as those between standard and non-standard forms of employment, are needed to reduce income inequality.

Policies that invest in human capital of the workforce are needed. This requires better training and education for the low-skilled. The latter would serve to boost their productivity potential and future earnings. Over the past two decades, the trend to increased education attainment has been one of the most important elements in counteracting the underlying increase in wage inequality in the longer run. Policies that promote the up-skilling of the workforce are therefore key factors to reverse the trend to further growing inequality…..”

 

 

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 *      *     *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]
Washington DC USA

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------
PAHO/WHO Website

Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
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IMPORTANT: This transmission is for use by the intended
recipient and it may contain privileged, proprietary or
confidential information. If you are not the intended
recipient or a person responsible for delivering this
transmission to the intended recipient, you may not
disclose, copy or distribute this transmission or take
any action in reliance on it. If you received this transmission
in error, please dispose of and delete this transmission.

Thank you.