Health Equity: The Vision for a Fairer and Healthier World

As September signals the start of the formal academic year, students from all communities across Canada prepare for the year of learning ahead. Yet significant cultural variations may emerge to illustrate the diversities and dynamism of the student group as a whole. Equity raises awareness about these important variations with reference to fair access and participation in basic needs such as health and education, to transform social systems that serve everyone equally within their unique contexts.

The World Health Organization (WHO) describes health equity as a “fundamental human right”. Equity is the absence of unfair, avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically or by other dimensions of inequality (e.g., sex, gender, ethnicity, disability, or sexual orientation). Health equity is achieved when everyone can attain their full potential for health and well-being.

In our Canadian context, Equity represents a foundational value of our Constitution, focusing on the values of Justice and Fairness. It’s also important in the context of the Charter of Rights and Freedom, where it intersects with our unique Canadian visions of Pluralism and Inclusion. Canada’s commitment to Universal Health Coverage highlights the role of equity in our healthcare system – availability, affordability, and equal healthcare coverage for all – providing free and fair healthcare for all Canadians despite the diversities of their demographics, linguistic, cultural, social or economic contexts. (1)

According to the World Health Organization, health and health equity are determined by the “conditions in which people are born, grow, live, work and age. The challenge lies in the acknowledgement of the realities that disparities in people’s living conditions are often results of discrimination, stereotyping, and prejudice based on sex, gender, age, race, ethnicity, or disability”, in addition to the exclusive systemic norms.

Health equity issues were brought to attention recently by COVID-19 data, which indicated that people worst affected by the pandemic largely represent vulnerable communities, such as “older people with pre-existing severe illness; socially disadvantaged people with serious health conditions such as heart disease and diabetes; people without Internet access unable to receive the latest information to protect themselves; people unable to afford out-of-pocket payments for treatment; and the socially excluded such as homeless people or migrants. They also include people suffering from unintended negative consequences of the measures introduced to contain COVID-19 such as those exposed to domestic violence or older-person or child abuse during lockdowns, negative effects on education, employment, and mental health.” (2)

To make health equity a reality, three strategies for action are often suggested: (a) people and community engagement to build trust in the system, (b) collection and monitoring of data about health disparities and (c) the need for the health sector to work with other sectors that can influence health equity, such as education or agriculture, environment, or transport, finance, or legal protection.

It is encouraging that the Canadian Medical Association Policy Statement on Health Equity (2013) refers to the WHO definition and builds its Actions aligned with Social Determinants of Health factors. Alberta Health Services has established a Diversity and Inclusion Council in our province and released its Anti-Racism Statement. The Alberta Medical Association has also formed its Joint Physician Advocacy Committee to raise awareness about income equities for physicians, elder care and women’s reproductive health.

If we, as citizens of Alberta and the globe, want to achieve a fairer and healthier world for all, we must raise our awareness about health equity.

  1. Canada Health Act, The Senate of Canada. Ch 17
  2. Chaudhuri ER. The Syndemic of Inequity and COVID-19 in Virtual Care. J Med Internet Res. 2022 Jun 1 ;24(6):e37717. doi: 10.2196/37717.

 

Esha Ray Chaudhuri PhD

ERC is a senior Education and Equity policy consultant with over three decades of local and global work experience in teaching, research and fieldwork.

October 2022