Social Values in Health Care Systems
John B. Davis, Robert McMaster in Health Care Economics, 2017
In this chapter we have characterized the chief ethical goal of public health programs as promoting health while paying particular attention to the relationship between health inequality and social inequality. In effect, from their health care systems perspective, public health programs seek to promote health and level the health inequality playing field at the same time. Our argument, then, was that the constraint such programs face when individuals are stigmatized in hierarchical societies can in principle be addressed when we move beyond the pure outcomes focus of standard health care thinking and emphasize the abilities that people have to act as agents of their own health. When people’s agency is promoted, recognizing the role that shared intentions play in activating agency, people are individualized rather than categorized, and are more likely, we believe, to act to improve their health wellbeing.
Introduction
Siân Griffiths, Davide J Hunter, Sir Kenneth Calman in New Perspectives in Public Health, 2017
With her arrival and with the support of the Secretary of State for Health, Frank Dobson, a renaissance in public health seemed about to happen. In her Foreword to the first edition, the Minister highlighted the importance of addressing health inequalities: ‘health inequality is unacceptable in a civilised society and we must bend our efforts to a long-term haul to reduce them’ (Jowell 1999). She also stressed the key role of partnership: ‘the new public health is about partnership and mutual responsibility at all levels of society and between all levels of society – individual, community and national’. And in stating that the new public health ‘is as much about wider socio-economic and environmental policies as it is about those policies that fall within the portfolio of the Department of Health’, she acknowledged the importance of the cross-government agenda. Indeed, ‘joined-up’ government was an early theme of the Labour government.
State case study
Edward M. Rafalski, Ross M. Mullner in Healthcare Analytics, 2022
As the COVID pandemic slowly comes to a close, the multi-sector capacity built across Chicago is seen by many as a catalyst for longer term change in the way we do public health. Most importantly, the COVID-19 pandemic, coupled with the city’s reckoning with longstanding systematic racism, has led to public commitments by local institutions to work alongside communities to dismantle racist systems and to internally dismantle practices that perpetuate inequitable health outcomes. In June 2020, 36 hospitals and health centers signed an open letter to the Chicago community explicitly naming racism as a public health crisis and collectively committing to work to improve health equity by focusing on over-burdened and under-resourced communities most affected by inequities.8 Specific commitments include examining institutional policies through a health equity lens, improving access to primary and specialty care, continuing focus on reducing the burden of chronic disease on communities, supporting investments “that create innovative solutions to achieve enduring improvements in access, quality and health outcomes for our communities,” committing to hire locally and to diversify leadership, providing anti-racism and implicit bias training to healthcare workers, and advocating for a greater emphasis on social needs. As we continue to work through COVID-19, it is imperative to build upon the accelerated progress toward addressing racism and health inequities. Many institutions have these intentions, but it will be important that they be held accountable to their commitments. Data is a critical element in creating transparent accountability.
The Fifth Face of Fair Subject Selection: Population Grouping
Published in The American Journal of Bioethics, 2020
Moreover, the next problem of how to delineate “minority groups” and how to understand the “sufficient representation” of a group in a clinical trial is also far from obvious. This leads us to the second issue, which stems from a surprising claim that “clinical research is a social practice from which all members of society benefit” (see also: “knowledge that fairly benefits all members of society”). It is surprising because the authors do not notice that many social practices may benefit (or harm) one group or another without benefiting (or harming) all members of these groups. This problem has been discussed in health care justice literature, with some authors (such as Daniel Hausman) opposed to defining inequalities in health across individuals, while others (like Kasper Lippert-Rasmussen) arguing that we should define health inequality across individuals (see their papers in Eyal et al. 2013). Again, let me demonstrate this by means of a very simple example: one could argue that affirmative action as a tool to promote racial diversity at universities benefits the group of African-Americans in the US (as a group). But this does not imply that it benefits “all members” of this group, e.g. it would be highly surprising that this policy would (directly) benefit President Obama’s daughters.
The effect of job security on safety behavior with the moderating role of salary: a structural equation model
Published in International Journal of Occupational Safety and Ergonomics, 2022
Mohammad Abri, Shahram Vosoughi, Jamileh Abolghasemi, Jamshid Rahimi, Hossein Ebrahimi
Economic status is another factor that may influence safety behavior. Social and economic status are known as a major cause of health inequality. Those living in poor, low-salary social and economic environments are exposed to higher risk [18,19]. Human societies are separated into different social classes, and each belongs to a particular social and economic class according to specific criteria of economics, education, personal wealth and profession. Nowadays, the kind of employment, the hours of unemployment and holidays vary based on social classes. In fact, people from the upper classes generally have more knowledge and information. For this reason, decision-making for their lifestyle is based on awareness and knowledge of the issues of health. But people with low socioeconomic status do not have desirable behavior and attitude toward health [18,20].
The importance of equal treatment: Medical students’opinions on affirmative action, equal treatment and discrimination
Published in Health Care for Women International, 2019
Heidi Siller, Bettina Dickinger-Neuwirth, Nikola Komlenac, Margarethe Hochleitner
Worldwide, efforts are undertaken to research, understand and eliminate gender inequality in health care (Denton, Prus, & Walters, 2004). Examples for such inequality are women experiencing a delay in receiving adequate treatment when having chest pains (Ravn-Fischer et al., 2012; Bruins Slot et al., 2012), or health inequality being interwoven with education, socio-economic status, ethnicity, migration, age and so forth (Betancourt & King, 2003; Braveman, 2014; Kapilashrami & Hankivsky, 2018), thereby highlighting structural determinants influencing health (Denton et al., 2004). To confront gender inequality in health, it is urged that sex and gender be included in research, teaching and practice (Day, Mason, Lagosky, & Rochon, 2016; Schiebinger & Stefanick, 2016), but also to make the medical workforce more diverse to reflect the diversity of the population, an aim not only relating to gender, but also, for example, to ethnicity (Betancourt & King, 2003).
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