Inequity in health within countries

Inequalities in health among social classes

Nature

There is strong evidence that income maldistribution significantly aggravates inequalities in health.

Background

Inequity in health within countries emerged as a global concern in the mid-20th century, notably highlighted by the 1978 Alma-Ata Declaration, which underscored disparities in health outcomes linked to social and economic factors. Subsequent reports, such as the WHO’s 2008 Commission on Social Determinants of Health, deepened understanding of how systemic inequalities persist across diverse national contexts, prompting international calls for targeted policy interventions. https://www.who.int/publications/i/item/WHO-IER-CSDH-08.1

Incidence

In 1991 in the UK a study of 10,000 civil servants confirmed that social class strongly affects health. The higher civil service grades were found to be much healthier than their clerical colleagues. Families on low incomes have also been shown to be eating unhealthy diets.

According to a 1999 report, poor residents in Lima, Peru, paid private vendors as much as $3 per cubic meter for buckets of often-contaminated water while the more affluent paid 30 cents per cubic meter for treated municipal tap water.

Claim

Inequity in health within countries is a grave injustice that cannot be ignored. It is unacceptable that access to quality healthcare, life expectancy, and well-being are determined by income, race, or geography. This disparity perpetuates suffering, stifles potential, and undermines social progress. Addressing health inequity is not just a moral imperative—it is essential for building fair, thriving societies. We must demand urgent, systemic change to ensure health is a right for all.

Counter-claim

Inequity in health within countries is vastly overstated and not an important problem. People’s health outcomes are primarily determined by personal choices and genetics, not social or economic factors. Resources should not be wasted on trying to equalize health when individuals are responsible for their own well-being. Focusing on health inequity distracts from more pressing issues and leads to unnecessary government intervention in people’s lives.