Defining equity in health
Defining equity in health
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DOI：
10.1136/jech.57.4.254
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发表时间：
2003-04-01
影响因子：
6.3
通讯作者：
Gruskin, S
中科院分区：
文献类型：
--
作者：
Braveman, P;Gruskin, S
研究目的：提出一个健康公平的定义，以指导操作和测量，并讨论在定义这一概念时明确性的实际重要性。设计：概念讨论。设置，患者/参与者和主要结果：不适用。结论：为便于计量和操作，健康公平是指在健康方面不存在系统性差异（或在健康的主要社会决定因素中）具有不同水平的潜在社会优势/劣势（即财富、权力或声望）的群体之间的差异。健康方面的不平等有系统地使已经处于社会不利地位的群体（例如，由于贫穷、女性和/或被剥夺权利的种族、族裔或宗教群体的成员）在健康方面处于更不利的地位;健康对福祉和克服社会不利地位的其他影响至关重要。公平是一项道德原则;它也符合人权原则并与之密切相关。拟议的公平定义支持落实可达到的最高标准健康权，这一权利体现在社会最不平等群体的健康状况上。评估健康公平性需要比较更多和更少的社会群体之间的健康及其社会决定因素。这些比较对于评估国家和国际政策是否导致或远离卫生领域的更大社会公正至关重要。
Study objective: To propose a definition of health equity to guide operationalisation and measurement, and to discuss the practical importance of clarity in defining this concept.Design: Conceptual discussion.Setting, Patients/Participants, and Main results: not applicable.Conclusions: For the purposes of measurement and operationalisation, equity in health is the absence of systematic disparities in health (or in the major social determinants of health) between groups with different levels of underlying social advantage/disadvantage - that is, wealth, power, or prestige. Inequities in health systematically put groups of people who are already socially disadvantaged (for example, by virtue of being poor, female, and/or members of a disenfranchised racial, ethnic, or religious group) at further disadvantage with respect to their health; health is essential to wellbeing and to overcoming other effects of social disadvantage. Equity is an ethical principle; it also is consonant with and closely related to human rights principles. The proposed definition of equity supports operationalisation of the right to the highest attainable standard of health as indicated by the health status of the most socially advantaged group. Assessing health equity requires comparing health and its social determinants between more and less advantaged social groups. These comparisons are essential to assess whether national and international policies are leading toward or away from greater social justice in health.