CommentaryPathways of influence on equity in health
Section snippets
Contributions of the literature to knowledge about the genesis of inequity in health
Recent definitions of equity in health characterize it as the absence of systematic and potentially remediable differences in one or more aspects of health between groups of people characterized socially, geographically, or demographically (International Society for Equity in Health, undated).1 This conceptualization
Possible pathways of influences on equity in health
These research findings suggest possible pathways of effect. Variability according to measure of health provides the basis for postulating that pathways differ depending on the health goal. Inequities in case fatality suggest relatively greater salience of health services whereas inequities in incidence lend relatively greater weight to social factors (including life course influences). Inequities in prevalence, in death rates, and in life expectancy reflect both the occurrence as well as the
Implications for future research
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Almost all studies focus on average (area-wide) health, e.g., overall rates of infant mortality, and, therefore, do not provide information on equity in (distributions of) health. Systematic differences in overall health levels across countries reflect inter-country differences, but neither they nor within-country studies examine the impact of societal factors on distribution of health within countries. The development of mapping technology could enhance the availability of data on
Implications for future research and development of interventions
In view of the likely importance of many societal influences and the relative dearth of studies examining their relative influence on distributions of health, a more concerted approach to identifying and measuring a minimum core set including the most salient policy, economic, and environmental characteristics, seems warranted. Cultural characteristics and ingrained behaviors undoubtedly play a role also, at least in particular countries (Cooper, Ordunez, Iraola, Munoz, & Espinosa-Brito, 2006;
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2016, International Encyclopedia of Public Health