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Poverty, Equity, Human Rights and Health

Author: P Braveman and S Gruskin
Date: 2003
Size: 7 pages (626 KB)

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Summary

How do poverty, equity and human rights relate to health? This study, by the University of California, suggests that they are closely linked conceptually and operationally and that each provides valuable, unique guidance for health institutions' work. Equity and human rights perspectives can contribute to health institutions' efforts to tackle poverty and health. Focusing on poverty is essential to operationalising those commitments.

The links between the concepts of poverty, equity, and human rights in relation to health are many and profound. Both equity and human rights principles dictate striving for equal opportunity for health for people who have historically suffered discrimination. Achieving equal opportunity for health entails alleviating the health-damaging effects of poverty and marginalisation. It also requires reducing disparities between populations in the underlying conditions necessary to be healthy. These include education, living standards and environmental exposures. Thus, both human rights and equity perspectives require that health institutions deal with poverty and health not only by providing care to improve the health of the poor but also by helping to alter the conditions that create, exacerbate, and perpetuate poverty and marginalisation.

Governments are accountable, as parties to human rights treaties, for setting benchmarks and targets towards progressive achievement of full realisation of human rights. Equity and human rights principles require that health institutions systematically consider how the design or implementation of policies and programmes may directly or indirectly affect social marginalisation, disadvantage, vulnerability or discrimination. These principles also:

• Require the identifying and overcoming of obstacles such as language, cultural beliefs and discrimination that keep disadvantaged groups from receiving benefits of health initiatives.
• Provide a universal frame of reference for identifying inequitable conditions, which may be a matter of dispute.
• Play a crucial role in agenda-setting by strengthening consensus about the existence of inequitable health disparities and the need to reduce them - particularly where certain groups are excluded from decision-making.
• Shift actions to relieve poverty and ensure equity from the field of charity to the domain of law.
• Provide a legal obligation, through international human rights instruments, to develop policies that aim towards an equal opportunity to be healthy.
• Can highlight the responsibility of wealthier countries to seek out the causes and consequences of poverty within and beyond their borders.

Health institutions can deal with poverty and health within a framework encompassing equity and human rights by:

• Institutionalising the systematic and routine application of equity and human rights perspectives to all health sector actions.
• Strengthening and extending the public health functions that create the conditions necessary for health.
• Implementing equitable health care financing, which should help reduce poverty while increasing access for the poor.
• Ensuring that health services respond effectively to the major causes of preventable ill-health among the poor and disadvantaged.
• Monitoring, advocating and taking action to address the potential health equity and human rights implications of policies in all sectors affecting health, not only the health sector.

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Source: Braveman, P., and Gruskin, S., 2003, ‘Poverty, Equity, Human Rights and Health’, Bulletin of the World Health Organisation, vol. 81, no. 7, pp. 539-545
Author: Center on Social Disparities in Health, http://familymedicine.medschool.ucsf.edu/csdh/