Health inequities in medical practices

This article was exclusively written for The European Sting by Ms. Shanzay Naveed, a 4th year MBBS student at Allama Iqbal Medical College, Pakistan. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Over the past half-century, understanding of health and health care disparities including underlying social, clinical, and system-level contributors, has increased. Yet disparities persist. Inequities in health care access persist, particularly for racially/ethnically minoritized populations and economically, socially, and geographically disadvantaged populations.

Racism and bias have exacerbated access issues and resulted in inequities in access to

care. Access is “the opportunity to identify health care needs, to seek health care services, to reach, to obtain, or to use health care services, and to actually have a need for services fulfilled. While all populations are relevant to the discussion of access to care, widespread inequities in access to care disproportionately exist for racially/ethnically minoritized populations and economically, geographically, and socially disadvantaged groups.

These inequities are exacerbated when considering an individual’s or population’s intersectionality i.e., the overlapping experiences of discrimination for people who identify with multiple social dimensions. Two main clusters of root causes of health inequity include first one is the intrapersonal, interpersonal, institutional, and systemic mechanisms that organize the distribution of power and resources differentially across lines of race, gender, class, sexual orientation, gender expression, and other dimensions of individual and group identity and the second one is the unequal allocation of power and resources—including goods, services, and societal attention—which manifest in unequal social, economic, and environmental conditions, also called the social determinants of health.

The factors that make up the root causes of health inequity are diverse, complex, evolving, and interdependent in nature. It is important to understand the underlying causes and conditions of health inequities to inform equally complex and effective interventions to promote health equity. Health equity is the state in which there is “a fair and just opportunity for everyone to attain their highest level of health”.

Health equity, however, continues to be threatened by the historical and contemporary injustices that create obstacles to health care access and thereby reinforce health inequities. Such structural barriers to health equity can include a low density of health care providers in underserved areas, decreasing primary care density in rural areas, poor transportation infrastructure, lack of adequate broadband high‐speed internet access, and gaps in insurance coverage, which exacerbate inequitable access to care.

The importance of addressing health inequities is increasingly recognized in modern strategies for improving healthcare and public health outcomes. At the same time, improving health and eliminating health disparities requires equitable access to socioeconomic resources known as social determinants of health (SDoH) including assets and income, affordable education, healthy food, clean water, and means to pursue healthy lifestyles.

The SDoH data are increasingly used to guide health equity assurance efforts in public health. Pursuing health equity through action on social determinants of health is particularly relevant for those who engage daily in the battle to overcome racial and ethnic and other health disparities—health differences that are closely linked with current or historical social, economic, and/or environmental disadvantage. Health equity goals focus on eliminating disparities as well as improving the overall health of populations affected by disparities.

About the author

Shanzay Naveed, a 4th year MBBS student at Allama Iqbal Medical College, is an affiliated member and Assistant Director of PUBSSD at IFMSA. Her 5 articles have already been published on European Sting, 6 stories on TWS Publications and an article & a 2 stories on Brewing Minds. She is in organizing team of AIMC Scientific Conference 2022 and Iqbalian Scientific Conference 2024. She is Volunteer Resource Secretary at VFHAT, Assistant Director of Education and Networking Team of AJRS and Vice President of IQS. She has presented her research on SCICON 2022. She has attended VCON’23 and NGA’23.