The History of Health Equity: Concept and Vision

Abstract

The origins of the concept of health equity can be found in the history of social medicine, especially since the mid-nineteenth century. Men such as Rudolf Virchow, Friedrich Engels, Andrija Stampar, and others clearly recognized that social and class inequalities led to inequities in health. This essay traces the subsequent history of the concept of health equity, and poses questions about the translation of this idea into practice.The World Health Organization (WHO) Constitution (1946) proclaimed that "the highest standards of health should be within reach of all, without distinction of race, religion, political belief, economic or social condition [1]." Two years later, in 1948, the United Nations, in a response to the Nazi holocaust, adopted the Universal Declaration of Human Rights [2] which set a standard by which the human rights activities of all nations, rich and poor alike, were to be measured. It states that "everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control." It also states that "Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, color, sex, language, religion, political or other opinion, national or social origin, property, birth or other status" [3].Twenty-three years later, in 1971, Julian Tudor Hart coined what he termed "the inverse care law" in his article about the British National Health System (NHS). As he described the inverse care law: "the availability of good medical care tends to vary inversely with the need of the population served." [4]. This was, of course, a play on the inverse square law of physics. Hart said that the inverse care law could be observed at its fullest extent when medical care was exposed to market forces, and argued that "a just and rational distribution of the resources of medical care should show . . . at least a uniform distribution."

Determinants of Antenatal Healthcare Utilisation by Pregnant Women in Third Trimester in Peri-Urban Ghana

“…It is generally acknowledged that the health status of people is influenced by a variety of factors which are outside the domain of the public health system [21]. It is therefore imperative to address the origin of ill-health when maternal health is discussed [22–25]. Health differences exist because of a combination of behavioural, structural, material, and cultural factors [26].…”

Os contributos da alfabetização em saúde para o sistema, os profissionais de saúde e os pacientes: O círculo virtuoso da comunicação na saúde

“…A equidade em saúde é justiça social em saúde 28 . Um passo significativo está na articulação de políticas e práticas que podem conduzir ao ideal da equidade na saúde e na capacidade de convocar o compromisso social e a vontade política de transformar essa visão em realidade 29 .…”

Rethinking the Central Role of Equity in the Global Governance of Pandemic Response

“…It is widely accepted that equity is central to global health and should be the guiding principle in global efforts to improve the health and lives of all people around the world (Fee and Gonzalez 2017 ; Plamondon and Bisung 2019 ). The current global response to COVID-19—which has been mostly inward looking and nationalistic—calls this premise into question.…”