Understanding and reducing disparities in health

October 23-25, 2006: "The conference focuses on three broad areas of action influencing health disparities: policy, prevention, and healthcare. It emphasize both basic research on the behavioral, social, and biomedical pathways giving rise to disparities in health and applied research on the development, testing, and delivery of interventions to reduce disparities in these three action areas. The conference employs a multi-level analytic framework (i.e., ranging from individuals to societies). It includes research relevant to a wide range of population groups (e.g., variation by SES, race, ethnicity, gender) residing in the United States, while not attempting to provide detailed analyses of each and every group. Consideration is given to multiple public health issues and their interactions (e.g., multiple morbidities rather than single illnesses) and to risk factors or causal processes common to various health conditions (e.g., smoking, diet, exercise, access to health care).


For the purposes of this conference, we are defining these action areas as:

POLICY: The means employed by governments and other institutions to influence the function and well-being of individuals, groups, communities, and society as a whole.

PREVENTION: Interventions at the individual, group or community level to provide targeted audiences the knowledge and skills to avert or minimize health risks.

HEALTH CARE: The "

Health, ethics and law

From: Equity, Health & Human Development [EQUIDAD@LISTSERV.PAHO.ORG]; em nome de; Ruggiero, Mrs. Ana Lucia (WDC) [ruglucia@PAHO.ORG])
Available online PDF [87p] at: http://papers.ssrn.com/sol3/papers.cfm?abstract_id=931703

“……This article offers an alternative theoretical framework for health ethics, policy and law, integrating both substantive criteria and procedural mechanisms - a joint scientific and deliberative approach - to guide health-system reform and allocation of scarce health resources. It appeals to a particular vision of the good life: human flourishing, which values health intrinsically and more highly than non-intrinsic or solely instrumental social goods, such as income. This view gives special moral importance to what I have called health capability. Health capability constitutes a person's ability to be healthy; it includes health functioning and health agency.

This paradigm sketches a joint scientific and deliberative approach, employing a public scientific process that combines the evidence base of medicine and public health with the expert opinions of physicians and public health experts with input from individuals. This view contrasts with paradigms in which consumers alone, physicians or public health experts alone, strict algorithms or cost-benefit calculations, shared decision making within an informed consent model, fair procedures, or third parties, such as insurers, make health care decisions.

The main focus of the article is on what I call shared health governance, a paradigm in which individuals, providers, and institutions work together to empower individuals and create an enabling environment for all to be healthy. Shared health governance extends beyond the individual patient-doctor relationship to the institutions that oversee the health sector. Shared health governance incorporates individuals' decisions for themselves and for their society at large.

This shared health governance model can potentially improve individuals' health and health agency and decrease costs. Evaluation must consider costs because we live in a world of scarce resources and every resource has an alternative use, so its expenditure corresponds with an opportunity cost. Therefore, some limits are necessary and individuals and society, through shared health governance, must use these resources parsimoniously by evaluating both equity and efficiency….” (au)

Social Inequalities in Health: New Evidence and Policy Implications -- Kristensen 333 (7579): 1177 -- BMJ

Social Inequalities in Health: New Evidence and Policy Implications -- Kristensen 333 (7579): 1177 -- BMJ: "Do we really welcome one more book on social inequalities in health now? Or have we had sufficient explanations, suggestions, and "beyond-the-Black-Report" analyses? There will be some that think so. None the less, I strongly commend this book. It is the result of a five year European Science Foundation Programme on "Social Variation in Health Expectancy in Europe," and includes contributors who are among the most distinguished scientists in the field. In nine chapters, they present state of the art reviews combined with selected results from recent interdisciplinary research. The difference of opinions in explaining social inequalities in health are not reflected or discussed in depth in this book. I would rather characterise it as a product built on a basic consensus.
Social Inequalities in Health concentrates on three issues: life course influences, psychosocial adversity, and the role of macro-social determinants of health. The overarching aim is to move beyond . . . [Full text of this article]"