There is a growing sense that the "health gap" between socioeconomic groups is getting worse in many countries. To address this gap, conceptual clarity and empirical evidence are needed along with a greater focus on equity in policy-making. This book is designed to present cutting-edge research and policy analysis to a wide non-specialist readership of students, professionals and policy-makers. It brings together in one volume new perspectives on the conceptual foundations of health equity, empirical evidence on the scale and nature of he inequities in health in twelve countries around the world, and assessments of the associated policy developments and their implications for the future. It aims to help build global capacity to measure, monitor and interpret developments in health equity at a national and international level. The in-depth country analyses draw on epidemiology, demography, economics and other fields to approach health inequalities from several different angles. The topics covered range from adolescent livelihoods in Tanzania to the health burden of indigenous peoples in Mexico, from health equity in Japan to the gender gap in life expectancy in Russia. The book is a unique demonstration of global cooperation in bringing together and giving equal weight to work on health equity carried out in the southern and northern hemispheres.
Reviewer:Linda C. Baumann, PhD, RN, CS, FAAN(University of Wisconsin-Madison)
Description:This book is the first publication of the Global Health Equity Initiative (GHEI), an international network of researchers and policy experts studying inequities in health. The GHEI helps to ensure that countries most affected by health inequities are included in this work. The book is organized using four key elements related to inequity: values, describing inequities, exploring the root causes, and building more equitable heathcare systems.
Purpose:The purpose is twofold. First, to present both conceptual issues of inequities in health, such as ethics, social determinants, gender, measurement, healthcare financing, and global health policy. Second, to provide chapters on specific countries to illustrate these issues. These are worthy aims and the book guides the reader through critical concepts to illustrative examples. The chapters seem somewhat uneven in meeting the purposes. A chapter devoted to the United States is a rather technical report of a study of health inequity (premature mortality and functional disability) across race, gender, and income group. It provides little of a country overview. The chapter on Vietnam provides a broader historical overview of the country's healthcare system and growing inequities in access to healthcare.
Audience:The editors never explicitly state for whom the book is intended. Its organization and content makes the book well-suited for use as a course text in global studies or population health. This book will also be a valuable reference for researchers, policy makers, and scholars of health inequity. The five editors are experts in the field from the United States, the United Kingdom, Sweden, and Banglaldesh and reflect the global view of population issues contained in the book.
Features:The book covers conceptual issues related to health inequities and provides chapters of country-specific illustrations of these issues in a format that is attractive, with readable text and numerous and effective black-and-white photographs. There is a detailed table of contents, an index, and unique features such as short biographical paragraphs of contributors and reviewers and a glossary of key terms in the area of health inequity. The glossary contains definitions of terms such as "absolute poverty" and "horizontal equity" and terms from epidemiology and biostatistics. The only shortcoming is that some of the chapters cover highly technical measurement issues and others are very general and conceptual. It is not clear for what level of reader the book is intended. My hunch is that it is meant to present a variety of depth of discussion since the purpose is to compile research on health inequity in a book that will be accessible to a variety of researchers, practitioners, and scholars.
Assessment:The book is more effective than several recently published books on global health issues. The organization and content, from concepts to examples, makes it well suited for use as a text. The chapters devoted to conceptual and measurement issues provide in-depth discussion and critical analysis of root causes of inequity. In the concluding chapter it is noted that health measures based on population averages are not reliable indices of what is happening to the health of different groups in society. It is an important perspective that this book helps to highlight.