The lottery of birth
The lottery of birth

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The lottery of birth

1.2.4 Health inequalities

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Figure 6

Along with material inequalities, inequalities of health and education remain some of the biggest problems that individual countries and global organisations face and the World Health Organization (WHO) sums up the current key health inequalities in the ten points below.

Most of the figures here relate to comparison/inequality between countries but again, within-country inequalities also exist. The extent of it varies between countries (Latin American countries, for example, are more unequal than some Asian countries even though they are all usually described as less developed countries).

The World Health Organization (WHO) 10 key health inequalities:

1 Health inequities are systematic differences in health outcomes

Health inequities are differences in health status or in the distribution of health resources between different population groups, arising from the social conditions in which people are born, grow, live, work and age. Health inequities are unfair and could be reduced by the right mix of government policies.

2 Every day 21 000 children die before their fifth birthday

They die of pneumonia, malaria, diarrhoea and other diseases. Children from rural and poorer households remain disproportionately affected. Children from the poorest 20% of households are nearly twice as likely to die before their fifth birthday as children in the richest 20%.

3 Maternal mortality is a key indicator of health inequity

Maternal mortality is a health indicator that shows the wide gaps between rich and poor, both between and within countries. Developing countries account for 99% of annual maternal deaths in the world. Women in Afghanistan have a lifetime risk of maternal death of 1 in 11, while a woman in Ireland has a risk of 1 in 17 800.

4 Tuberculosis is a disease of poverty

Around 95% of TB deaths are in the developing world. These deaths affect mainly young adults in their most productive years. Contracting the disease makes it even harder for these adults to improve their personal economic condition and that of their families.

5 About 80% of non-communicable diseases are in low- and middle-income countries

In low-resource settings, healthcare costs for non-communicable diseases (NCDs) can quickly drain household resources, driving families into poverty. The exorbitant costs of NCDs are forcing 100 million people into poverty annually, stifling development.

6 Life expectancy varies by 36 years between countries

In low-income countries, the average life expectancy is 57, while in high-income countries, it is 80. A child born in Malawi can expect to live for 47 years while a child born in Japan can expect to live 83 years.

7 There are alarming health inequities within countries, too

For example, in the United States of America, African Americans represent only 12% of the population but account for almost half of all new HIV infections. There is no biological or genetic reason for these alarming differences in health.

8 Health disparities are huge in cities

In London, men’s life expectancy ranges from 71 years in Tottenham Green ward (Haringey) to 88 years in Queen’s Gate (Kensington and Chelsea) – a difference of 17 years. According to the findings of the London Health Observatory, when travelling east from Westminster, each tube stop represents nearly one year of life expectancy lost.

9 Health inequities have a significant financial cost to societies

The European Parliament has estimated that 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 defence spending (1.6% of GDP). This arises from loses in productivity and tax payments, and from higher welfare payments and health care costs.

10 Persistent inequities slow development

Over 800 million people in the world live in slum conditions, representing about one third of the world’s urban population. The likelihood of meeting the health-related Millennium Development Goals is lowered by poor health service delivery to hard-to-reach populations such as these.

The links between levels of inequality and child and maternal mortality (which you will be looking at more closely next week), poverty, disease, life expectancy, economic development and housing are clear. It’s also clear that many of these factors are intersectional, bound up together and cannot be separated from each other.

In the next section, you will find out about an example of health inequality in the UK.

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