Health & Primary Care

Biography

Dr. Ana Rita Gonzalez graduated from the Johns Hopkins University with a Doctorate of Science in Health Policy and Management, and she holds a Masters in Health Services Administration and Certificate in Public Health. She is the President and CEO of Policy Wisdom LLC, in Florida, USA, an organization that works with governmental and non-governmental entities to shape policies on health, safety, and the environment.  Elizabeth Fee holds a PhD in the History and Philosophy of Science from Princeton University, USA and is currently Chief Historian at the National Library of  Medicine, National Institutes of Health, USA.

Abstract

Today, there is a 38-year age gap between countries with the lowest and highest life expectancy rates. A child born in Sierra Leone can expect to live for 46 years while a child born in Japan may expect to live for 84 years.  Most people in health care and health policy would agree that health equity is a desirable goal, but can it ever be achieved?  Historically, there have been repeated efforts to define health equity with questions whether it means equity in the delivery of health services or equity in health status – the latter being a great deal more difficult to measure, and to attain. To guide actions at the policy and programmatic level we first need to collect and analyze data on health equity. 

We used World Bank data to make cross-country comparisons of inequality using absolute and relative equity measurements (differences and ratios). We used aggregate indicators, such as infant mortality rate and life expectancy to illustrate trends in health and income, and regions of the world as equity stratifiers. We know that between and within countries, there is an inequitable distribution of power, money, and resources. We find that the measures of health we selected – infant mortality and life expectancy -- mirror these economic and political inequities. The evidence points to the existence of extensive (and widening) social inequities in health. This poses a public health challenge of the highest order.