Global Health Challenges: 

Achieving Equity and Reducing Disparities

The world is facing numerous global health challenges, from the ongoing COVID-19 pandemic to the threat of climate change. These challenges have laid bare the inadequacies of health systems and the disparities in access to healthcare that exist between different groups of people. In order to address these challenges and improve global health, it is essential to focus on achieving equity and reducing disparities.

Health equity refers to the state in which everyone has a fair and just opportunity to attain their highest level of health. This requires ongoing societal efforts to address historical and contemporary injustices, overcome economic, social, and other obstacles to health and healthcare, and eliminate preventable health disparities

  Achieving health equity means ensuring that everyone has access to the care they need, regardless of their race, ethnicity, gender, socioeconomic status, or other factors.

Disparities in health outcomes are often the result of differences in the social deter

minants of health. These are the conditions in which people are born, grow, live, work, play, and age that affect their health risks and outcomes. Factors such as income, education, employment, housing, and access to healthy food can all impact a person’s health. Addressing these social determinants of health is key to reducing disparities and achieving equity.

One way to advance health equity is by improving access to healthcare. This means ensuring that everyone has access to affordable, high-quality care when they need it. It also means addressing barriers to care such as lack of transportation or insurance coverage. Improving access to care can help reduce disparities in health outcomes between different groups of people.

Another way to achieve health equity is by addressing the root causes of disparities. This means tackling issues such as poverty, discrimination, and racism that can impact a person’s health. It also means addressing systemic issues such as unequal distribution of resources or lack of representation in decision-making. By addressing these root causes, we can create a more just and equitable society where everyone has the opportunity to live a healthy life.

Social determinants of health are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. They can be grouped into several domains:

1. Economic Stability: This includes factors like income, employment status, and job security. Economic stability can influence a person’s ability to afford healthcare or maintain a healthy lifestyle.

2. Education: Access to quality education can affect health outcomes. Education level is often linked to better health, more positive health behaviors, and greater access to healthcare.

3. Health Care Access and Quality: This includes access to health services, timeliness of care, health insurance status, and language/literacy. Lack of access or poor quality care can lead to unmet health needs, delays in receiving appropriate care, inability to get preventive services, and hospitalizations.

4. Neighborhood and Built Environment: Factors such as housing, neighborhood crime rate, access to healthy foods and recreational facilities, and exposure to environmental toxins can significantly influence health outcomes.

5. Social and Community Context: This includes social cohesion, civic participation, discrimination, incarceration, and stress.

6. Working Life Conditions: The conditions of a person’s work environment can impact their health. This includes job insecurity and the physical conditions of the workplace.

7. Food Insecurity: Lack of reliable access to a sufficient quantity of affordable nutritious food can lead to malnutrition or obesity.

8. Housing and Basic Amenities: Access to safe housing and basic amenities like clean water and sanitation facilities is crucial for maintaining good health.

9. Early Childhood Development: The early years of life are critical for health development. A nurturing environment can promote physical and mental health well into adulthood.

10. Social Inclusion and Non-discrimination: Social inclusion involves ensuring all citizens have the rights, resources, and opportunities they need to participate fully in society.

Addressing these social determinants is fundamental for improving health and reducing longstanding inequities in health.

What is the relationship between social determinants and health outcomes?

  The relationship between social determinants and health outcomes is complex and multifaceted. Social determinants of health (SDH) are the non-medical factors that influence health outcomes. 

  They are the conditions in which people are born, grow, work, live, and age, as well as the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies, and political systems.

  Research shows that social determinants can be more important than healthcare or lifestyle choices in influencing health outcomes. For example, numerous studies suggest that SDH account for between 30-55% of health outcomes. In addition, estimates show that the contribution of sectors outside health to population health outcomes exceeds the contribution from the health sector.

  The SDH have an important influence on health inequities - the unfair and avoidable differences in health status seen within and between countries. In countries at all levels of income, health and illness follow a social gradient: the lower the socioeconomic position, the worse the health. Addressing SDH appropriately is fundamental for improving health and reducing longstanding inequities in health, which requires action by all sectors and civil society.

What are some examples of health outcomes?

Health outcomes are the changes in health that result from measures or interventions, and they can be positive or negative. Here are some examples:

1. Mortality Rates: This is a measure of the number of deaths in a particular population, scaled to the size of that population, per unit of time.

2. Disease Incidence and Prevalence: Incidence refers to the number of new cases of a disease in a population over a specific time period, while prevalence refers to the total number of cases of a disease in a population at a given time.

3. Health-Related Quality of Life: This measures how well a person functions in their life and their perceived well-being in physical, mental, and social domains of health.

4. Patient Satisfaction: This measures how satisfied patients are with their healthcare provider or healthcare experience.

5. Physical Functioning: This includes measures such as mobility (e.g., can a person walk a certain distance), activities of daily living (e.g., can a person feed themselves or bathe themselves), etc.

6. Survival Rates: This is the percentage of people in a study or treatment group who are alive for a certain period after they were diagnosed with or started treatment for a disease.

7. Patient Safety Incidents: This includes measures such as healthcare-associated infections, falls resulting in injury, pressure ulcers, etc.

8. Readmission Rates: This is the rate at which patients who have had a recent hospital stay need to be readmitted to the hospital.

9. Life Expectancy: This is the average number of years that a person is expected to live based on their current age.

10. Avoidable Deaths: These are deaths that could have been avoided through effective public health and prevention policies or more timely and effective healthcare.

11. Short-term Health Outcomes: These include outcomes such as survival of a heart attack following in-hospital care or reduced joint pain following knee replacement.

In conclusion, global health challenges require us to focus on achieving equity and reducing disparities. This means improving access to care, addressing the social determinants of health, and tackling the root causes of disparities. By working together towards these goals, we can create a healthier world for all.