Talk:Health equity/Archive 1

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Archive 1

Between-country view

This article focuses exclusively on health inequity/equity within single countries, not on global health inequities. Both between- and within-country views should be represented in this important topc. I would add the former, if I had the time, see e.g. articles by Marmot, one of the leading authorities on health inequality for ideas: http://eprints.ucl.ac.uk/676/1/Microsoft_Word_-_MM_Lancet_365_1099_UCL_eprints.pdf. 109.202.225.55 (talk) 21:50, 4 September 2011 (UTC)

Religious practices

I think we need to add about religious practices. The problems of childbirth related to female genital mutilation, for example. violet/riga (t) 08:51, 9 June 2006 (UTC)

Definition

I would have thought that the term health disparity would also refer to people who are disadvantaged by being from a poor socioeconomic background as it states here [1]. In Europe we use the term health inequality to describe this. Perhaps it is a cultural difference: where it is assumed in the US that poorer people would have poorer health, to people in European countries, such as the UK, this is something that we are disturbed by and are trying to eradicate. If this is not the case, then perhaps we ought to reword the first paragraph. --Vince 17:32, 19 February 2007 (UTC)

This has been added in, although the article did previously discuss how socioeconomic factors also resulted in health disparities. And it is wrong to say that people in the USA are not disturbed by health disparities and aren't trying to eradicate them. Best, --Alabamaboy 15:27, 13 March 2007 (UTC)
I am sorry if my comments were offensive. I should have worded it better. I think I was annoyed! Importantly though, I am pleased we have reached a consensus for the current version of the page. --Vince 16:09, 13 March 2007 (UTC)


The following discussion is closed. Please do not modify it. Subsequent comments should be made in a new section. A summary of the conclusions reached follows.
Merged healthcare inequality and Health disparities to Health equity c. Feb 2011. --KarlB (talk) 04:50, 2 July 2012 (UTC)

Er, where is the supposed discussion about merging health disparities with healthcare disparities?

I would have no objection to that as long as it was clear that health disparities are not necessarily wholly or even partially the result of disparities in access to or quality of care. I would also like it to be clearer -- if it can be agreed -- that "disparities" are not simple differences but rather differences that have reasonably clear roots in unequal access to social, economic, and/or political resources, and are therefore a matter of justice and not simple biological difference. Somewhat Agree (talk) 17:43, 5 July 2008 (UTC)

Merge I think merging the healthcare inequality article makes sense. It could go into Health disparities or Social determinants of health (or some of each), but there seem to be 4 or 5 articles here that cover almost the same material. Zodon (talk) 09:03, 14 October 2008 (UTC)

The term "health disparities" is used almost exclusively in the US and conceptually creates groups of "others" (those with worse health outcomes). "Health Equity" is used in the rest of the world and is more inclusive, equity impacts everyone (Olivia Carter-Pokras, Claudia Baquet. 2002. "What is a Health Disparity?" Public Health Reports. 117:426-34). My professional opinion (as a professor of Public Health) is that a new page should be started called Health Equity and put both health inequality and health disparities there, but include a link from an "empty" health disparities and inequalities pages that takes the reader to health equity. U C L A Steve (talk) 01:41, 5 January 2010 (UTC)

Merge Health and Social Class

Might be worth consolidating the article on social class health disparities into this one. Or at least linking them more tightly. Zodon (talk) 08:50, 14 October 2008 (UTC)

"Health disparities" is uneven at best and confuses disparities in access, use, and outcomes, concepts with critical importance. I think that this article should be combined with Health and Social Class as well as Health Inequalities, as the data tend to show that disparities in health care outcome are directly related to socioeconomic class and education, as well as certain elements of religion/culture; the research also suggests that racial and ethnic minorities tend to have poorer outcomes primarily as a result of their socioeconomic and education status. If there is persuasive evidence of people of similar socioeconomic and educational backgrounds having dissimilar healthcare OUTCOMES due to discrimination in the provision of healthcare based on race or ethnic origin, I have yet to see it. 98.125.163.100 (talk) 20:10, 6 March 2009 (UTC)

Merger complete, let's edit!

So the merger discussion hasn't been touched for over two years, so I decided to be bold and do it, especially seeing as no one had objected in all that time. The former articles healthcare inequality and Health disparities have been merged into this brand new article. There's still a great deal of cleanup to be done, as my initial goal was to avoid losing useful content. The old articles were a bit of a mess to begin with and the merger didn't help, so there's a lot of inconsistent terminology and mixing of disciplines here. I'll start sorting it out in the coming days, and would welcome all interested parties to help.

Personally, I'd like to see this article focus as more of a summary of the issues and research across different types of equity areas, with links to main articles like Ethnicity and health and Race and health (these should be merged too if anyone wants to take that on), LGBT issues in medicine, etc... where possible. Obviously, speak up if there are directions you think it should go.

I'm also not sure how Social determinants of health fits into this all. Thoughts? Zachlipton (talk) 00:43, 2 February 2011 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Inequalities among Canadians

I brought this section over from http://en.wikipedia.org/wiki/Social_determinants_of_health and put it under Inequalities in Health because it seems to flow better here than on the SDH page. In the process, I cut the text on tips for better health and for staying healthy as well as the list of social determinants. Haejelee (talk) 15:26, 19 March 2012 (UTC)

This

This article is well written, but poorly sourced. A controversial topic like this begs for page numbers. --Muchosucko 02:36, 11 August 2005 (UTC)

This was the first Wikipedia article I ever wrote and as such my referencing was weak. Ihave all of the original source material, so when I get a chance I'll go back and add in-line sources.--Alabamaboy 19:07, 11 August 2005 (UTC)
"Controversial" topic? In the US? not in Europe at least. Health inequalities are widely acknowledged across all European countries, starting with Britain. —The preceding unsigned comment was added by 82.244.56.75 (talk • contribs) 2006-07-01 00:30:12 (UTC)

References have now been added.--Alabamaboy 18:28, 11 February 2007 (UTC)

A better reference for # 5 is the U.S. Surgeon General's 2001 report, Mental Health: Culture, Race, and Ethnicity—A Supplement to Mental Health: A Report of the Surgeon General. URL: http://www.ncbi.nlm.nih.gov/books/NBK44243/ — Preceding unsigned comment added by 208.120.233.144 (talk) 15:27, 11 June 2012 (UTC)

Causes of Health Inequality

Two well researched causes of health differences between ethnoracial populations that went unmentioned are genetics and IQ. As for genetics, refer to Winkler (2010) "Admixture Mapping Comes of Age." As for IQ, refer to the 2009 special addition of Intelligence "Cognitive Epidemiology." For example: Wilson et al, 2009. Cognition and survival in a biracial urban population of old people; Reeve and Basalik (2010) Average state IQ, state wealth and racial composition as predictors of state health statistics Partial support for ‘g’ as a fundamental cause of health disparities. To note, racial differences in intelligence co-vary with racial differences in SES, but there is a large residual difference after controlling for SES. To put it another way, intelligence is an independent predictor of racial health disparities. The cause of the intelligence differences, of course, are unclear. --71.65.235.169 (talk) 22:28, 22 June 2012 (UTC)Chuck

Affordable Care Act (ACA) role in ending health disparities

I think this section is unintelligible, contains numerous typos, and is disjointed. Someone more favorably disposed to the ACA than I am might want to fix it. That endeavor might start with an improved section title that doesn't suggest that the ACA, plus some other unspecified events/laws/entities are going to eliminate (end) health disparities.Thomas Pain 67 (talk) 15:32, 15 July 2012 (UTC)

Comment on subsection: Healthcare equity and sex

Hi! I am part of a Wikipedia contribution class on Poverty, Gender, and Human Development at Rice University. I was reading this article and I would like to make a few comments and suggestions on the “Healthcare equity and sex subsection.”

Currently, the amount of material on gender health disparities is very sparse even though gender disparities in health have been well-documented. The only area on topic that was touched upon in the subsection is insurance coverage. While I think this is an important issue since it relates to one's access to health care, I feel that the subsection also needs a discussion on some of the more canonical areas of gender inequality in health, such as health outcomes differences (e.g. mortality & disease) between men and women. Additionally, considering that health has a huge influence in shaping people’s lives and hence their social productivity, it would be great if there was coverage on the social and economic implications that might result from persistent gender disparities in health. This would make the content of the subsection more comprehensive and holistic.

One issue I have with the current content of the subsection is that it seems to suggest that men are generally at the lower end in terms of gender health inequality. While this might be true for certain cases, it is actually women who tend to fare poorer in various health outcomes and access to health care. Evidence of this can be found in World Development Reports published by international organizations as well as peer reviewed articles from public health journals. In light of that, I feel that the content of the subsection – which only talks about men being at the lower end of health inequality – is not only highly unbalanced, but also a misrepresentation of reality. All in all, I feel that the subsection can be improved by including more canonical information and revising the content to make it more representative of actual state of the issue.

On a side note, I am also planning to create a stand-alone entry on health disparities in health and I was wondering if the outline I have for this new entry can be used to structure the content of the revised version of the subsection. The current outline I have in mind for this new article is to begin with some background information on health inequality and how gender serves as an axis of differentiation that usually works against women. After this, I plan to provide some examples and statistics of gender disparities that are currently in existence around the world. I also intend to include a section that describes some of the factors that result in gender disparities in health, like sex-selective abortion and preferential care. Following that, I will proceed to highlight the impacts and implications of having gender disparities, both socially and economically. Finally, I will list some of the countermeasures recommended by academics to address this issue, as well as some of the policies implemented that have led to a reduction of gender disparities in health.

If you do have any thoughts on my comments with regards to the “Health equity and sex” subsection or have any feedback on the outline I have for gender disparities in health article I intend to write, do drop me a message or chat me up! Cheers!

Benongyx (talk) 13:53, 6 March 2013 (UTC)

International Coverage

Hi All,
It seems that, as it stands, this article mostly concerns itself with health inequity in the US. I propose the creation of a separate article for content specifically regarding the US, while this base article would concern itself with equity on a more general/international scope. I am considering tackling the project of improving this article myself, however I wanted to see what the community thinks before I go ahead and start the process.
Any thoughts on this matter would be greatly appreciated, thanks!
Jpoles1 (talk) 22:37, 24 January 2014 (UTC)

Health Equity Rework

Hi All,
Wanted to give a bit of an update on my proposed edits to the Health Equity page. As I previously noted, this page has a lot of room for improvement; the article focuses on the issue of health equity, only with regard to the United States. Given that health equity is a global issue, and Wikipedia is meant to be a comprehensive source of information with a worldwide view of any given subject, there is a lot of important content that is currently absent. I plan to rework the page, maintaining some of the current information and supplementing it with significantly more international content. Given that health inequities are often found across specific divisions in the population, I wish to approach the article and organize the content from this perspective. I will discuss the topics of gender, sexuality, location, socioeconomic status, and education, and how they relate to health equity worldwide (information for which I have a number of reputable sources). In the case of education for example, I will discuss the correlation of education with improvements in healthcare. In developing nations like Tajikistan, for example, a lack of higher education was correlated with lower contact with healthcare professionals, when it came to maternal health care. In this sense, education serves as an important determinant in population health. With regard to the information on the US, I will have to cut down some of the content from this article, and I am considering adding it to a new article specifically detailing Healthy Equity in the US. Thoughts on this addition would be appreciated.

Jpoles1 (talk) 04:49, 24 February 2014 (UTC)

Article suggestions

Hi Jpoles1,

Your contribution to "Health equity" includes a vast array of information adapted from a large number of sources. You incorporate case studies from many different countries, which gives the reader a more nuanced understanding of the issue from a global perspective. However, in order to increase comprehensiveness, I would recommend adding more information to support some of your general claims (e.g. "...undeserved [sic] regions have experienced a slight increase in inequity..."). In addition, in some cases, you could include more in-text information about your sources; for example, when you cite a study about racial inequity in Australia from 1996, you could include the name of the author who published the study. Overall, the article is clearly structured, but I found it confusing that you listed Thomas LaVeist's six key factors that contribute to health disparities (socioeconomic conditions, social and physical environments, access to quality care, cultural competency, health literacy, and empowered health consumers), but then used only some of these factors to organize your subsections. Finally, I think you could improve the article by including illustrations; graphs or charts might enhance the reader's understanding of the issue. Great work!

Jak8 (talk) 21:33, 31 March 2014 (UTC)

Article Feedback

Hello Jpoles1,

You have made substantial and comprehensive contributions to this article! The information you have provided references a large number of credible scholarly sources; I commend you for this! Some of the discussion you have included, such as the discussion of what health equity and inequity are, could be communicated in a manner that is easier for audiences of all academic levels to understand. In essence, this article’s readability could be improved by simplifying some of the language used. You have done a really great job and I look forward to following your contribution. Good luck!

Best Wishes, Brookeethleen (talk) 01:38, 1 April 2014 (UTC)

Revisions

Regarding GEF addition by EuroHealthNet {{OTRS pending}} Phinespedia (talk) 09:48, 15 June 2015 (UTC)


Hi all,
I've taken all of your suggestions into consideration and made a ton of edits to the page improving grammar, neutrality and wording to make the entire article more clear. Thanks for all of the help!
Best,
Jpoles1 (talk) 05:17, 8 April 2014 (UTC)

Disambiguation

I would suggest adding a disambiguation pointing to the article on Healthequity (Health plan/HSA administration Company) http://en.wikipedia.org/wiki/HealthEquity . — Preceding unsigned comment added by 98.111.215.56 (talk) 16:20, 30 April 2014 (UTC)

Advocacy

Regarding the addition of advocacy copyright infringement: {{OTRS pending}} 

Phinespedia (talk) 10:49, 15 June 2015 (UTC)

Bias

"examplar of the NHS"? "In the United Kingdom, which is much more racially harmonious"?? Regardless of politics, why add this stuff? FuzzyCatPotato (talk) 02:57, 27 September 2015 (UTC)

Incidental or causal?

Can we discuss whether or not selection bias jaundices the collection of data which supports researchers' intention to discover? Without denying the gist of their conclusions, is it possible that 10-20% of the conclusion could come from the hypotheses of the researchers?

For instance, if behavior has a causal relation to outcomes, but researchers seek to find other correlations and ignore direct behavioral inputs, could the researchers' bias effectively cover up what we thought we had already known or felt or thought with other data which smothers out previous discoveries by merely ignoring such data?

Effective, evidence-based health education as a targeted intervention may be indicated by a review of all relevant literature, in order to 'nudge' the more immediately causal factors (unhealthful behaviors, lack of knowledge to choose and thus 'access' more directly optimal foods and behaviors, etc.).

Consider this triangular graphic which emphasizes a 3-fold goal in health equity, which promotes the objectives in the Triple Aim of Health Equity: 1) Expand our communities' deep, mature, and evidence-based understanding of what creates and enhances, as well as what reduces or endangers or threatens human health, 2) Take a “health in all policies” approach with health equity as the explicit goal for all individuals and groups, and 3) Strengthen communities’ capacity to create their own health-supporting future for all members and participants in their communites. MaynardClark (talk) 21:34, 3 April 2017 (UTC)

LGBT minority group health disparities

In this section there are several references that are more than 5 years old. Would it be appropriate to delete some of the older referenced information and replace with more updated stats and sources? Jam329 (talk) 02:03, 17 September 2017 (UTC) I'm also wondering if it would be appropriate to remove sources that don't meet MEDRS guidelines although this isn't strictly a medical article.Jam329 (talk) 02:06, 17 September 2017 (UTC)

Goal for LGBT minority group health disparities- to update and expand. For the next draft I plan to add more comprehensive information regarding specific disparities, make further note of differences in these disparities among different subsections of the LGBT population, and further improve citations. Jam329 (talk) 05:20, 17 September 2017 (UTC)

Goals for Healthcare Equity and Sex

Better organization and more in depth information regarding the differences in disparities among developed and developing nations, as they are extremely different and complex. In the next draft I hope to bring more information and better distinguish between the disparities felt in different parts of the world. One difficulty here is that gender/sex differences are often confounded by race and socioeconomic status. Ecanepa (talk) 05:25, 17 September 2017 (UTC)

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Health Inequalities Section

Hi! After doing some research and learning about health equity in class, I know that there is a difference between equity/ inequity and equality/ inequalities. This Wikipedia article discusses health equity, and there is a section on inequality. Reading this without knowing that the two concepts are different may be confusing, because some people may think inequity is the same as inequality. I think it would be helpful to either change this to have a section called "health inequities" or to clarify that there is a difference. If I misread anything, please let me know! Mollycoleman514 (talk) 03:13, 6 March 2020 (UTC)

Hi I am so glad Mollycoleman514 said that and made those edits because when I saw it said health equity and health disparities were the same, I was a little shocked. I like these references. First from the Robert Wood Johnson Foundation: “Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.” <ref>https://www.rwjf.org/en/library/research/2017/05/what-is-health-equity-.html<ref> And on health disparities, And from Healthy People 2020: "If a health outcome is seen to a greater or lesser extent between populations, there is disparity. Race or ethnicity, sex, sexual identity, age, disability, socioeconomic status, and geographic location all contribute to an individual’s ability to achieve good health. It is important to recognize the impact that social determinants have on health outcomes of specific populations." <ref>https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities<ref> The straight definitions from Healthy People 2020 for both are as follows: "Healthy People 2020 defines health equity as the “attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparities.” <ref>https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities<ref>. Healthy People 2020 defines a health disparity as “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion.<ref>”https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities<ref>. I think we need to remove the lines that says: "Health equity synonymous with health disparity refers to the study and causes of differences in the quality of health and healthcare across different populations.[4]" What do other people think? DisabilityAdvocacy4U (talk) 21:28, 7 March 2020 (UTC)

Or in addition to the more complicated definition, we may want to also include a simple definition from CDC (Centers for Disease Control & Prevention): What is Health Equity? Health equity is when everyone has the opportunity to be as healthy as possible. What Are Health Disparities? Health disparities are differences in health outcomes and their causes among groups of people. <ref> https://www.cdc.gov/minorityhealth/strategies2016/index.html<ref> DisabilityAdvocacy4U (talk) 21:46, 7 March 2020 (UTC)

I have been working on this article for my Wiki course, and got some feedback from my instructor that I wanted to pass along since it pertains to sections I didn't write. She suggested that the phrase "are able to access certain resources" be expanded upon to specify which resources, that there needs to be a citation for the statement "health is a basic human right and human need, and all human rights are interconnected". I'm not sure who originally wrote those, but doesn't anyone have ideas for how to address?Datadecathlete (talk) 17:37, 13 April 2020 (UTC)

Globalize

This article appears to have a specific emphasis on the US, particularly in the section #Health inequality and environmental influence, #Disparities in access to health care, and #Poor health and economic inequality. Adding this talk page message to provide a rationale as to why I added this maintenance tag. Elysia (Wiki Ed) (talk) 19:18, 22 April 2020 (UTC)

Improving the Health Equity Wikipedia

Hi, I'd like to improve this Wikipedia page. I noticed that the health equity Wikipedia page focuses heavily on the United States, and could use a section on inequality and health outcomes in Low-and-Middle-Income countries (LMICs). This section would cover the unequal impacts of epidemics, infant mortality, etc. I would also create a separate section on ethnic and racial disparities in the United States, adding more information on black poverty rates and the correlation with poor health. SarahD12345678910 (talk) 01:26, 16 September 2021 (UTC)

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Time for the template banner on worldwide view be removed?

It covers information from several countries, it seems to be time to remove it, but I would like to hear from others. @John P. Sadowski (NIOSH): TMorata (talk) 14:16, 6 June 2023 (UTC)

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Promotional language?

The mention of names and acknowledgements in the second paragraph of Affordable and accessible healthcare summits does not conforms to Wikipedia expectations. The adjectives used are also problematic.

TMorata (talk) 13:38, 22 September 2023 (UTC)

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