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HLTC05H3 Lecture Notes - Scalability, World Health Report, Health Equity

Health Studies
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R Song

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HLTC05 FALL 2012
Week # 1 Readings Chapter 1 Equity, Social Determinants and Public Health Programmes
Achieving greater equity in health is a goal because achieving specific global health goals and development
targets without ensuring equitable distribution is pointless
There is limited documentation of experiences w/ interventions and implementation approaches to reduce
or halt growing inequities in health
This shortfall is addressed by the Priority Public Health Conditions Knowledge Network (PPHCKN)
o Focuses on practise looking at practically options for action
o Expand knowledge territory in a systematic way
Old problems still exist MALARIA, TB, HIV/AIDS
o Due to tools that have been altered by usage DRUG RESISTANCE
o Not sufficiently recognized and appropriately dealt with the inequities underlying health stats.
Most problems are perpetuated by the inequities caused by the way we organize societies
o Inequities fuel emergence of new public health problems and result from them
Most health systems concerned with DOWNSTREAM interventions but there needs to be upstream
addressing of determinants of health
PPHCKN is looking at these issues from two perspectives
o Health conditions perspective
o Programme perspective
Three key events happened
o Commission of Social Determinants of Health presented final report
o 2008 World Health Report placed health equity as the central value
o Global recession impacted the government’s ability to provide and finance social services which
are known to be determinants of health
Degree of social exclusion, education, housing, diet, violence, unemployment etc.
Countries have signed up to close the gap within a generation
Structural determinants and daily life conditions constitute the social determinants of health that explain
health inequity
o Distribution of power, income, goods and services, health care, work conditions, education, access
to health care,
Health equity is a moral position and a logically-derived principle
o Inequity is unjust because it is avoidable we have the tools at the ready, the social conditions are
not right however
Three principal measures to describe inequities
o Health disadvantages due to differences between segments of populations or between societies
o Health gaps arising from the differences between the worse off and everyone else
o Health gradients differences across the whole spectrum of population
Equity also about opportunity, empowerment, security, and dignity that all people want regardless of it
being a rich or poor country
Causal relationship between social factors and health conditions is not known
Key principles of building evidence base:
o Commitment to the value of equity; identifying and addressing gradients and gaps; focusing on
causes, determinants and outcomes; and understanding social structures and dynamics
The term priority is reserved only for:
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