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Ten facts on health inequities

By Milliam Murigi
Thursday, July 30th, 2020
Stethoscope. Photo/Courtesy

In all countries, whether low, middle or high-income, there are wide disparities in the health status of different social groups. The lower an individual’s socioeconomic position, the higher their risk of poor health. MILLIAM MURIGI explores some of these gaps.

Inequities are real and unfair

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, but could be reduced by the right mix of government policies.

21,000 children die daily 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 per cent of households are nearly twice as likely to die before their fifth birthday as children in the richest 20 per cent.

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 per cent of annual maternal deaths in the world. In Kenya, maternal mortality has remained high, at 400-600 deaths per 100,000 live births over the past decade.

Tuberculosis is a disease of poverty

Around 95 per cent of Tuberculosis (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.

80 per cent of NCDs are in low and middle-income countries

In low-resource settings, health care costs for non- communicable diseases (NCDs) can quickly drain household resources, driving families into poverty. The exorbitant costs of managing NCDs are forcing 100 million people into poverty annually, stifling development. Poverty is closely linked with NCDs. 

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.

There are alarming health inequities in rich countries too

For example, in USA, African Americans represent only 12 per cent 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.

Health disparities are huge in cities

 About 33 per cent of urban dwellers (within the world’s megacities) live in slums.

These populations are more likely to lack health insurance, face barriers to care, receive poorer quality care, and disproportionately use emergency systems. Residents are also in a position to be more exposed to infectious or sexually transmitted diseases, and more likely to be prone to drug or alcohol abuse.

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.

Interventions are cost effective

Public health programmes that reduce health inequalities can be cost effective.

Countries can give priority to such programmes (for example, improving access to cervical cancer screening in low income women) on efficiency grounds.

On the other hand, few programmes designed to reduce health inequalities have been formally evaluated using cost effectiveness analysis.