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From Fairness to Justice: How Can Health Resources Be Distributed According to Need to Be Truly Fair?
Health equity is rooted in access to social determinants of health, including wealth, power and status. Individuals who are chronically deprived of these three determinants are significantly disadvantaged by health inequalities and often face worse health outcomes. In this context, "fair" resource allocation does not mean simple formal "equality", but a reasonable allocation of resources based on the principle of individual needs.
"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."
According to the World Health Organization, health itself is a basic human right, and all human rights are interrelated. Therefore, health issues need to be discussed along with all basic human rights. According to the Centers for Disease Control and Prevention, health equity is “a state of affairs in which everyone has a fair and equitable opportunity to achieve the highest level of health.” Health inequalities are reflected in differences in health outcomes and access to health resources among different groups in terms of gender, race, and economic and social status.
There is a clear distinction between health inequalities and health injustices. The former refers to the disparity that exists even under the same access to medical services, while the latter refers to health disparities caused by unjust social structures.
The impact of socioeconomic status
Socioeconomic status is a strong indicator of health and one of the key factors in health inequalities. Economic backwardness limits an individual's health capabilities, and a lack of money affects their ability to access health resources. In terms of employment, a stable job can reduce the risk of poverty and naturally improves access to health services.
“A lack of financial capital impedes the ability to maintain good health.”
Children from high-income families and children from low-income families have a sharp contrast in their access to health resources. The former are more likely to receive necessary medical treatment. Taking China as an example, with the disintegration of the cooperative medical system, many rural poor have lost necessary medical insurance and cannot obtain the medical services they deserve.
Economic inequality and health outcomes
Growing economic inequality is positively associated with worsening health outcomes. Many studies show that life expectancy, mental health, substance abuse, and violence-related health outcomes are poorer in economically unequal societies. Especially in the United States, although its medical expenditure ranks first in the world, it still ranks at the bottom of life expectancy, showing the impact of relative inequality.
“The negative impact of relative inequality on health is evident at the international, national and institutional levels.”
Differences in economic equity between states have important implications for access to care. For example, health outcomes are generally better in more equal states in the United States.
The importance of education
The connection between education level and health care utilization is inextricably linked. Lack of health education can lead to people not correctly understanding diseases and reducing the probability of seeking medical help. Research shows that mothers with higher levels of education are more likely to receive medical care during pregnancy, which directly affects fetal health outcomes.
"Health education is an effective preventive measure that can significantly reduce the level of disease."
Inequality in educational resources also further exacerbates health inequalities. In poor communities, low-income families often have limited access to health information, making it difficult for them to receive necessary medical services.
The impact of spatial differences
Geographical factors may also limit access to health care for certain groups. For example, nearly 80% of rural areas in the United States are designated as "medically underserved" areas. Rural areas have a significant shortage of medical professionals compared to cities, resulting in generally poorer health outcomes for residents.
“Low life expectancy and high rates of chronic disease and obesity in rural communities form a significant part of current health problems.”
These issues have received some attention during the epidemic, but subsequent improvements still require continued efforts.
Race and health disparities
When it comes to race, significant health inequalities still exist in many countries. The United States has suffered from this problem throughout its history. To this day, white people and ethnic minorities still face disparities in the quality of medical care and insurance coverage. Research points out that unequal levels of economic participation and security are one of the fundamental reasons for this phenomenon.
"Black and Hispanic infant mortality rates are two to three times higher than those of other groups."
These data not only reveal current health disparities, but also remind us of the underlying factors behind the allocation of health resources.
So, in the face of so many health inequalities, how can we achieve a socially fair and just allocation of health resources?
