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Space and Global Health/Equity in Health Care/SDH and Health Inequity

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Social Determinants of Health and Health Inequity

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There is ample evidence that social factors, including education, employment and financial protection, environment, living conditions (housing, basic amenities), poverty, gender inequality, social inclusion and non-discrimination, structural conflict, nutritional status and ethnicity have a marked influence on how healthy an individual is, how health equity is affected both in positive and negative ways.[1] All countries – whether low-, middle- or high-income – there are wide disparities within the health status of various social groups. The lower an individual's socio-economic position, the upper their risk of poor health.

Let's take a glance at some examples.

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  • There is a difference of 18 years of life expectancy between high- and low- income countries.[2]
  • 85% of premature deaths cause of noncommunicable diseases occur in low- and middle-income countries.[3]
  • The children under 5 years old are 14 times more likely to die in Africa than the rest of the globe.[4]
  • Maternal mortality is a key indicator of health inequity - developing countries account for 99% of annual maternal deaths within the world. Women in Chad have a lifetime risk of maternal death of 1 in 16, while a girl in Sweden features a risk of but 1 in 10000.
  • Tuberculosis is a disease of poverty- around 95% of TB deaths are within the developing world.
  • There are alarming health inequities within countries, too- within America, African Americans represent only about 13% of the population but account for nearly half of all new HIV infections.
  • Health inequities have a big financial cost to societies- the losses linked to health inequities cost around 1.4% of gross domestic product (GDP) within the European Union – a figure almost as high as the EU's defense spending (1.6% of GDP).

Global Commission on Social Determinants of Health[5]

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Global Commission on Social Determinants of Health CSDH has identified three areas for critical action to combat the health inequities. These include:

  • Improve daily living conditions
  • Tackle the inequitable distribution of power, money and resources: the structural drivers of those situations of daily life (for example, macroeconomic and urbanization policies and governance);
  • Measure and understand the problem and assess the impact of steps taken: expand the knowledge base, develop a workforce that is trained in the determinants of health, and raise public awareness about the determinants of health.
  1. Ravindran, T.K. Sundari; Gaitonde, Rakhal, eds (2018). Health Inequities in India. doi:10.1007/978-981-10-5089-3. http://dx.doi.org/10.1007/978-981-10-5089-3. 
  2. "Uneven access to health services drives life expectancy gaps: WHO". www.who.int. Retrieved 2022-04-27.
  3. "Noncommunicable diseases: Mortality". www.who.int. Retrieved 2022-04-27.
  4. "Child mortality and causes of death". www.who.int. Retrieved 2022-04-27.
  5. "Commission on Social Determinants of Health". www.who.int. Retrieved 2022-04-27.