What are the structural factors generating health inequalities in the Americas? How should governments act to overcome such inequalities? To answer these questions, the Pan American Health Organization (PAHO/WHO) gathered twelve experts to set up the Commission on Equity and Health Inequalities in the Americas. Fiocruz former president and current coordinator of Centro de Relações Internacionais em Saúde - Cris/Fiocruz (Fiocruz Global Health Center), Paulo Buss, is one of the members.
The Commission worked on the theme for 2 years and on September 24th it delivered the executive summary of the Just societies, health equity and dignified lives report, with twelve recommendations for regional governments to tackle the theme (listed below).
Achieving equity in political, social, cultural, and economic structures
Protecting the natural environment, mitigating climate change, and respecting relationships to land
Recognize and reverse health equity impacts of ongoing colonialism and structural racism
Equity from the start––early life and education
Dignified life at older ages
Income and social protection
Reducing violence for health equity
Improving environment and housing conditions
Equitable health systems
Governance arrangements for health equity
Fulfilling and protecting human rights.
The report argues that access to good-quality healthcare is not conditioned to income only. A minimal investment is needed, state the experts. However, several factors like gender, race, and environmental aspects also interfere in health and access inequality. "There are drastic exceptions to the idea that good-quality healthcare is only a matter of getting richer", said Michael Marmot, Chairman of the Commission, from UCL Institute of Health Equity, when delivering the executive summary to Health ministers in the 56th PAHO Executive Committee.
"Inequality is all over the Americas: socioeconomic inequality, but also inequalities between indigenous and non-indigenous peoples; between African descendants and European descendants; between genders; between disabled and non-disabled people; between people with different sexual orientations; and between migrants and non-migrants. Excess inequality impairs social cohesion, leads to an unfair distribution of life opportunities and to health inequalities", said the Commission in its executive summary.
Check out the article written by the leader of the initiative, Michael Marmot, for The Lancet about the work and the conclusions of the Commission.