What is Health Equity: And How Does a Life-Course Approach Take Us Further Toward It?

Maternal and Child Health Journal - Tập 18 - Trang 366-372 - 2013
Paula Braveman1
1Department of Family and Community Medicine, Center on Social Disparities in Health, University of California, San Francisco, San Francisco, USA

Tóm tắt

Although the terms “health equity” and “health disparities” have become increasingly familiar to health professionals in the United States over the past two decades, they are rarely defined. Federal agencies have often defined “health disparities” in ways that encompass all health differences between any groups. Lack of clarity about the concepts of health disparities and health equity can have serious consequences for how resources are allocated, by removing social justice as an explicit consideration from policy agendas. This paper aims to make explicit what these concepts mean and to discuss what a life-course perspective can contribute to efforts to achieve health equity and eliminate health disparities. Equity means justice. Health equity is the principle or goal that motivates efforts to eliminate disparities in health between groups of people who are economically or socially worse-off and their better-off counterparts—such as different racial/ethnic or socioeconomic groups or groups defined by disability status, sexual orientation, or gender identity—by making special efforts to improve the health of those who are economically or socially disadvantaged. Health disparities are the metric by which we measure progress toward health equity. The basis for these definitions in ethical and human rights principles is discussed, along with the relevance of a life-course perspective for moving toward greater health equity

Tài liệu tham khảo

Sen, A. (1999). Development as freedom. New York: Random House.

UN Committee on Economic, Social and Cultural Rights (CESCR), General comment No. 20: Non-discrimination in economic, social and cultural rights (art. 2, para. 2, of the International Covenant on Economic, Social and Cultural Rights), 2 July 2009, E/C.12/GC/20. Available at: http://www.unhcr.org/refworld/docid/4a60961f2.html.

Institute of Medicine. (2007). Committee on understanding premature birth and assuring healthy outcomes, and board on health sciences policy. In R. E. Behrman & A. S. Butler (Eds.), Preterm birth: Causes, consequences and prevention. Washington, DC: The National Academies Press.

Lu, M. C., & Halfon, N. (2003). Racial and ethnic disparities in birth outcomes: A life-course perspective. Maternal and Child Health Journal, 7(1), 13–30.

Institute of Medicine. (2000). In J. P. Shonkoff & B. Phillips (Eds.), From neurons to neighborhoods: The science of early childhood development. Washington: National Academy Press.

Weiss, M. J., & Wagner, S. H. (1998). What explains the negative consequences of adverse childhood experiences on adult health? Insights from cognitive and neuroscience research. American Journal of Preventive Medicine, 14(4), 356–360.

Evans, G. W., & Kim, P. (2007). Childhood poverty and health: Cumulative risk exposure and stress dysregulation. Psychological Science, 18(11), 953–957.

Braveman, P. A., et al. (2005). Socioeconomic status in health research: One size does not fit all. JAMA, 294(22), 2879–2888.

Morenoff, J. D., Sampson, R. J., & Raudenbush, S. W. (2001). Neighborhood inequality, collective efficacy, and the spatial dynamics of urban violence. Criminology, 39(3), 517–558.

Adler, N. and J. Stewart (eds). (2010). The biology of disadvantage: Socioeconomic status and health, Vol. 1186, Ann. N. Y. Acad. Sci. New York.p 275.