The best Fight Against Health Inequalities

Almost two centuries have passed since the identification of the relationships between the social structure and the health situation of individuals, families, groups and communities. The topic has been of interest to researchers in the field of health, who have tried to answer questions that stimulate a broad inquiry in this regard.

For example: What social factors contribute to the health situation? Are morbidity and mortality rates certainly higher among poor people? How do socioeconomic conditions and the environmental environment influence individual and collective health? Why the differences in the health situation and life expectancy in people belonging to the same social group? Although the social factors-health situation link, it was established long ago, it is during the last three decades that interest in answering these questions has been reborn, considering health as a necessary condition for communities to progress and compete, in a much more dynamic and interrelated world.

These investigations have shown almost without objection that the main determinants of health are not directly related to health systems, but to income, education, human rights and access to basic services, the environmental situation, among others. Every day threats arise from these and new factors, therefore, the interest in continuing with these studies to contribute to the design and implementation of public policies that favor comprehensive social development is valid, to raise the level of health and well-being of the populations. Therefore, this work aims to offer relevant information on the issue of social determinants and inequalities in health policies.

Data Source

Documentary and bibliographic review on-line and in electronic format on the subject. The search for the social determinant descriptors, inequality and inequity in health, was carried out on the sites and web pages of well-recognized institutions and centers. Regarding ethnicity or race as a conditioning factor of social health disparities, the review of research carried out in Latin America was prioritized.

Data Synthesis

The identification, analysis, measurement and, finally, the explanation of the relationships between people's health status and their social conditions are not novel actions in health research, although they were revitalized in the last quarter of the 20th century. The first attempts to associate the health conditions of people with factors external to human biology emerged at the end of the 15th century, when diseases related to employment were identified.

Social Inequalities

Social inequalities in the early stage of child development are one of the main contributing factors to inequalities in adult life and, consequently, to the creation of an intergenerational circle of disadvantage:

The Commission on Social Determinants of Health of the World Health Organization
Emphasized the early stage of development (early child development)
As a fundamental part of the pathways and mechanisms by which social inequalities are produced and perpetuated in the adult population

This fact determines the importance of collecting social determinants in a systematic way in studies of child and adolescent health. On the other hand, it has been shown that the earlier the interventions to reduce social inequalities in health, the greater the probability that they will be more cost-effective.

Socioeconomic Position

The indicators used to measure the socioeconomic position of the adult population may be insufficient to address the social determinants of health and identify inequalities in minors. Currently, the economic crisis situation, changes in the family structure, social changes or migratory flows, among other factors, outline a new reality that may affect the health of the child and adolescent population in our country. Although inequalities according to gender, ethnicity or origin generally affect the entire population, in children they acquire a unique character by representing the moment in which social gender roles or differences derived from gender are generated and incorporated. For child health disparities here are some words.

Ethnic Origin

This fact represents a unique opportunity to promote equity from the beginning of childhood development and during adolescence. The study of social inequalities in health of the child and adolescent population represents a challenge due to the conceptual and methodological difficulty to measure the socioeconomic position in these age groups.

The conceptual model of social, human and financial capital proposed by Coleman has been the explanatory framework from which the socioeconomic position of the adolescent population and its relationship with health has been studied. Entwisle and Astone recommended measuring family income (financial capital), mother's education (human capital), and family and household structure (social capital).

They developed this idea and suggested including specific questions about race and ethnicity. Usually, in child health studies it is the parents who declare the information on the indicators of socioeconomic position, while in adolescents they are the ones who provide it. The methodological difficulty in obtaining information from adolescents, the controversy over the adequacy of using parents as a "proxy" and the biases of differential non-response between socioeconomic groups have motivated the creation and application of other measurement scales, such as scale household purchasing power or family affluence scale.