For more articles like this, check out Apolitical's health and wellbeing collection.

Across the WHO’s Europe region, more educated men are likely to live between about three and 15 years longer than less-educated men. More than half of the countries in the same area saw regional gaps in infant mortality stay the same or widen between 2005 and 2016.

These striking statistics come from a sweeping new analysis presented in the WHO’s report, Healthy, Prosperous Lives for All. Taken together, the data — and solutions presented alongside it — provides a clear roadmap for action to boost health equity.

Removing inequalities and boosting life expectancy could not only improve the lives of citizens, but can boost GDP by over 4%, according to the report.

"Instead of looking at health policy in isolation, health equity asks policymakers to consider its intersection with wider policy areas, such as housing, employment and transportation."

Defining equity

The WHO views “health equity” as the removal of avoidable and unfair differences among citizens which affects those citizens’ ability to access healthcare services.

The Robert Wood Johnson Foundation (RWJF), which supported the release of the report, stresses that health equity is different from equality (nb: Apolitical's Health and Wellbeing coverage is supported by RWJF's Global Ideas Fund at CAF America).

If equality means everyone is granted the same resources (e.g. equal pay), equity is about ensuring that everyone has what they need — which could mean giving more support to those in more difficult circumstances.

To learn more about health equity, take a look at Apolitical’s new field guide on structural racism in health.

Instead of looking at health policy in isolation, health equity asks policymakers to consider its intersection with wider policy areas, such as housing, employment and transportation.

A rounded picture

The report uses different trends to explore how health is measured; traditional indicators like life expectancy are measured alongside wellbeing indicators, like life satisfaction.

This variation in indicators provides a stronger picture of physical, mental and emotional health, the WHO believes. “Life expectancy is important, but it’s not enough to just cover life expectancy and nothing else. We also need to focus on the now — the health problems being faced by the current generation,” said Chris Brown, the Head of the World Health Organisation’s European Office for Health and Development.

“Often the missing link when it comes to health policy is human and social capital. Participation in education needs to be considered alongside access to care”

The analysis primarily considers factors like the quality, security and affordability of healthcare, alongside education levels and the ability of a person to weather economic shocks, like losing a job. Income insecurity is measured alongside social isolation and a resistance to ask for help.

By including non-traditional factors in its analysis, the WHO is pushing policymakers to think differently about healthcare. “The hours you work, the type of contract you have, and the security and affordability of your home all affect how we access healthcare,” said Brown.

As a result, the report highlights emerging groups who are not traditionally considered key targets by health policymakers, like school leavers who leave education at 16 years of age, or earlier. “Often the missing link when it comes to health policy is human and social capital. Participation in education needs to be considered alongside access to care,” Brown said.

Delivering equity

The report recommends that governments view health systems as partners when creating economic development plans, to drive cycles of inclusive growth.

The WHO suggests that policies to improve access to health services should not be prohibitively expensive or lead to increased financial hardship for patients. It sees reducing income inequality is vital to improve health. It also recommends promoting the removal of stigma from financial support from the state.

The report also features a variety of different case studies of successful health equity projects — from Armenia improving its rural drinking water infrastructure to building youth employment partnerships in Azerbaijan.

Getting governments to act

It’s crucial, the report said, that its recommended policies could be implemented by a national government in about four years — within what in many countries is a standard political cycle.

Responding to the four year challenge, Brown said: “We’ve got to change the narrative around health equity — it’s wrong that it takes long, incremental changes to see a difference. Change could happen quicker than you think.”

The suggested four year reform period sets an interesting challenge for governments. It’s no coincidence that the report will also be reviewed in four years, setting a deadline for re-evaluation.

The WHO is throwing down the gauntlet. It’s down to governments to pick it up. — Emma Sisk

[Photo credit: Unsplash]