Health equity is vital for a harmonious society with the potential to prosper. The root causes can be divided into two themes: structural inequity and social determinants of health. The root causes contributing to health inequity and disastrous health outcomes in specific communities should be analyzed. It is essential to understand the reasons to promote equal and effective interventions to save people’s lives. This is important because by saving a life, you are practicing justice, one of the main pillars of medical ethics.
According to this article, the umbrella term “structural inequity” refers to the systemic racism that prefers one group over another with whom they coexist. This is embedded in systems that control policy, make laws, and serve governments. Groups are classified based on their social class, ethnicity, race, or even gender identity in this criteria. The social determinant of health is the environment in which people interact daily across all age groups, dependent upon employment, income and wealth, social environment, and transportation. Any rational person who learns about the possible injustice would have dropped out of their social class, ethnicity, or whichever factor is about to cost them their health.
Another point was that providing health care to everyone would be costly and burden the economy, national security, and business viability. This is contradicting because poor health outcomes prevent the economy from thriving. In the long term, saving human lives and practicing fundamental human rights by allowing equal dispersity of resources can save the economy.
In 2020, the COVID-19 pandemic struck the world and continued to disrupt many lives as we waited for a vaccine. When the vaccine was made available, it was too expensive for low to middle-income countries to purchase. Additionally, the vaccine was granted emergency approval before conducting enough research on the possible side effects. This was a burden on low to middle-income countries that went the extra mile and bought the vaccines for their people because the side effects reported that they would not afford care. In middle to high-income countries, securing the vaccine and affording care if it fails was an advantage.
The authors report various “possible” ways of tackling this inequity, but then it raises whether these ways have been put into action? I have read and listened to many ‘health inequity’ activists, but we are in the year 2022 and are still facing catastrophic and shameful disparities. One may ask, what are we lacking? It is a complex issue because it requires strong and immediate actions by multiple power sources outside of health care.
The research has highlighted situations that are clear and robust. If two patients showed up to the emergency room and the only difference was their ethnicity, it could have life-changing health outcomes. The first perception that comes to mind when we categorize patients into male or female, blue or red, etc., impacts the treatment plan and thus their overall health. This is not fair because all people are created equal with the right to quality health care, and as a physician, I choose to spend most of my career advocating for them. At times when those patients don’t have a voice, this is where it is the physician’s job to speak on their behalf and shed light. The physician should be wise enough not to claim the spotlight on behalf of the unprivileged. This is medical ethics to me.
Sarah Murad is a medical student.
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