In preparation of People's Health Assembly II - part 13
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Defining equity in health
P Braveman, Department of Family and Community Medicine, Univer-
sity of California, San Francisco, USA
S Gruskin, International Health and Human Rights Program, Fran-
cois Xavier Bagnoud Center for Health and Human Rights, Harvard
University School of Public Health, USA
Adobe PDF file (5 pp. 132 kB):
http://jech.bmjjournals.com/cgi/reprint/57/4/254.pdf
For the purposes of measurement and operationalisation, equity
in health is the absence of systematic disparities in health (or
in the major social determinants of health) between groups with
different levels of underlying social advantage/disadvantage-
that is, wealth, power, or prestige. Inequities in health sys-
tematically put groups of people who are already socially disad-
vantaged (for example, by virtue of being poor, female, and/or
members of a disenfranchised racial, ethnic, or religious group)
at further disadvantage with respect to their health; health is
essential to wellbeing and to overcoming other effects of social
disadvantage.
Equity is an ethical principle; it also is consonant with and
closely related to human rights principles. The proposed defini-
tion of equity supports operationalisation of the right to the
highest attainable standard of health as indicated by the health
status of the most socially advantaged group. Assessing health
equity requires comparing health and its social determinants be-
tween more and less advantaged social groups. These comparisons
are essential to assess whether national and international poli-
cies are leading toward or away from greater social justice in
health.