Inequality And Disparity In Health Care

3.2. SOCIOECONOMIC-RELATED INEQUALITY AND INEQUITY IN HEALTH AND HEALTH CARE

3.2.1. Defining inequality and inequity in health and health care utilization

3.2.1.1. Terms inequality, inequity and disparity

In the health equity literature, the terms “inequality”, “inequity” and “disparity” are used interchangeably; however, as dictionary definitions, these are distinguishable. In the Cambridge Dictionary, these are defined as follows:

• Inequality – the unfair situation in society when some people have more opportunities, money, etc. than other people (Cambridge Dictionary 2016b)

• Inequity – the fact that a situation is not fair, or something that is not fair in a situation (Cambridge Dictionary 2016c)

• Disparity - a lack of equality

Because this definition enables policies to target eliminating the factors that cause avoidable and unfair differences in health rather than eliminating all health differences (Whitehead 1992). Additionally, the intuitive definition is easy to use in communication between policy makers, non-professionals and the public (Braveman

Nonetheless, fairness in health is cumbersome to measure due to its varied understanding across the cultural contexts (Starfield 2006). For that reason, the International Society for Equity in Health elaborated the definition by Whitehead with the purpose of researching and analyzing the health inequity and informing policy decisions as “Equity in health is the absence of systematic and potentially remediable differences in one or more aspects of health across socially, demographically, or geographically defined populations or population subgroups” (Starfield 2006).

Table 1. Some definitions of equity in health Definitions Sources

1 “Equity means that people’s needs, rather than their social privileges, guide the distribution of opportunities for well-being. In virtually every society in the world, social privilege is reflected by differences in socioeconomic status, gender, geographical location, racial/ethnic/religious differences and age. Pursuing equity in health means trying to reduce avoidable gaps in health status and health services between groups with different levels of social privilege”

(World Health Organization 1996, Braveman 2006) 2 “Equity in health is operationally defined as minimizing avoidable disparities in health its determinants-including but not limited to health care- between groups of people who have different levels of underlying social advantage” (Braveman,