Article Text

other Versions

PDF
Health systems: how much difference can they make to health inequities?
  1. Frances E Baum
  1. Correspondence to Dr Frances E Baum, Southgate Institute of Health, Society and Equity, Flinders University, GPO Box 2001, Adelaide, SA 5001, Australia; fran.baum{at}flinders.edu.au

Statistics from Altmetric.com

Persistent health inequalities are evident within and between countries. While in rich countries, such as Japan and Australia, the average life expectancy of people is over 80 years, in some African countries, such as Sierra Leone, it is only 45 years.1 Within countries, socioeconomic status difference creates considerable gaps in life expectancy.2 Health inequalities caused by avoidable and unfair socioeconomic or cultural inequalities are recognised as health inequities.3 Reducing these health inequities is a central concern of international agencies and national governments. Evidence on how best to achieve this reduction is improving and suggests that, while the health sector has a crucial role, responsibility for the reduction also lies with other sectors where the social and economic inequalities that drive health inequities are created and maintained.4 Health systems do not sit apart from these structural drivers of inequities but are entwined within them.

Economic globalisation has led to an increase in the commercialisation of healthcare services, has weakened national health systems (for instance through the imposition of structural adjustment packages in poor countries) and reduced the opportunity for comprehensive primary healthcare. Individuals’ opportunities to access healthcare are shaped by their education, income, social support and the nature of the health system they have available. The difference in health systems between low and high income countries is massive, and within both groups of countries, health systems differ widely. Contrast the privatised system in the …

View Full Text

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Health inequalities
    Miqdad Asaria Shehzad Ali Tim Doran Brian Ferguson Robert Fleetcroft Maria Goddard Peter Goldblatt Mauro Laudicella Rosalind Raine Richard Cookson