PHA-Exch> WHO report calls for global action: BMJ and Lancet Editorials

[Claudio Schuftan]

>From Ana Lucia Rggiero, PAHO.

 Editorial

*Tackling health inequities*

*WHO report calls for global action to ensure health equity within and
between countries *



*George Davey Smith and Nancy Krieger
*BMJ 2008;337:a1526, doi: 10.1136/bmj.a1526 - Published 3 September 2008



Available online<http://www.bmj.com/cgi/content/full/337/sep03_3/a1526?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&author1=Davey+Smith+&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&fdate=9/1/2008&resourcetype=HWCIT>



"…..Finally, an official report on health inequity has been published that
has the honesty and courage to say that "social injustice is killing people
on a grand scale."1 The report of the World Health Organization's Commission
on Social Determinants of Health synthesises evidence from a large and
disparate range of sources, while recognising that what constitutes evidence
is itself contested and not value free.2 It presents a wealth of data to
show the unquestionable link between economic, social, and bodily
wellbeing—within and across countries. In the case of life expectancy, these
embodied facts of social inequity3 can span the equivalent of a lifetime:
women born in Botswana can anticipate living an average of 43 years, half
that of the 86 years for women in Japan; between the poorest and most
affluent parts of Glasgow life expectancy in men ranges from 54 to 82 years.




Many official reports have documented social inequalities in health over the
past 170 years, from Chadwick4 to Sachs.5 Yet, in contrast to these reports,
which subtly (and not so subtly) emphasised the detrimental effects of poor
health induced by poverty on economic performance,6 the commission firmly
draws the arrow of causality from impoverished environments to ill health,
something that is clear to most of the world's population (if not to some
economists).



The ability of this report to make these conclusions rests on its
unprecedented broad scope—unlike many other reports that have focused on one
country or on groups of countries at similar economic levels, the commission
has produced a global picture of economic and social deprivation that makes
it impossible not to recognise the importance of economic redistribution,
health care, and the direct material consequences of poverty and social
inequality across the life course on health. …"



*The Lancet* 2008; *372*:689 - DOI:10.1016/S0140-6736(08)61282-9

Editorial

*Addressing the inequities in health: a new and vital mandate*

*The Lancet**,  Volume **372**, Number **9640**, 30 August
2008<http://www.thelancet.com/journals/lancet/issue?issue_key=S0140-6736(08)X6037-4>
***

http://www.thelancet.com/journals/lancet/article/PIIS0140673608612829/fulltext



"…..The Commission talks unashamedly about social justice, a phrase that is
used more by politicians than health professionals. But the inequities and
inequalities in health that exist today must surely prick the concern and
conscience of every physician. The problem for most doctors is likely to be
the twin feelings of hopelessness and impotence at the sheer scale of the
difficulty they face. Those feelings often translate into paralysis. The
Commission's most refreshing conclusion is that hopelessness, impotence, and
paralysis can be overcome by optimism, vigour, and muscular policy
responses. Why? Because the evidence already shows that much can be achieved
to reduce inequity and inequality…."
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