Inequities in health in Tamil Nadu: A study of Dharmapuri District
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Date
2014-12
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Development narratives: The political economy of Tamil Nadu. New Delhi: Academic Foundation; 2014.
Abstract
In public health, the concept of health inequity is often used to describe inequalities in
health that are perceived to be avoidable, unnecessary and unfair [1]. Equity – the
absence of particularly unfair differences - is different from equality – the absence of
differences in general. The use of equity rather than equality when assessing the nature of
differentials in health arises from the recognition that there are bound to be differences in
the health status of individuals, and for a number of reasons, many of these are random or
biological and hence unavoidable.
There is sufficient evidence now from across the globe to show that differences in health
status across social groups are not just the result of genetic endowments, life style or
differences in access to health services. Many studies have found that socially and
economically disadvantaged groups get more sick more often and have less access to
health services as compared to their more privileged counterparts even within the same
country or region. Most of these differences originate in inequities in access to social and
economic resources and living conditions essential for leading a healthy life [2-8]. These
differences in health are thus the consequence of denial of opportunities to be healthy,
and represent health inequities.
The use of the concept of health equity may appear to be in conflict with health equality,
as viewed from a human rights perspective, but this is not the case. While health equity is
not the same as equality, it may be seen as a commitment to increase the equality of
opportunity for health and human development for groups within a society who appear to
be suffering a lower health status as a result of social disadvantages or discrimination.
Equity, which embodies a dimension of justice, indicates that change should be in the
direction that is fair and just even if it means preferential treatment of disadvantaged
groups over others.
Pursuing equity in health means trying to reduce social disadvantages or their health
effects among disadvantaged groups; it thus requires selectively focusing on
disadvantaged groups. Yet, health policies and programmes continue to remain focused
on disease-specific interventions and outcomes. Inadequate attention paid to addressing
social determinants of health has contributed to a widening of the gaps in health status
between and across countries [9]. The recently appointed Commission on Social
Determinants in Health of the World Health Organization recognizes the need for
gathering more evidence, and systematizing and putting to better use available evidence
on inequities in health.