Content area
Full text
The burgeoning field of health inequalities research has given rise to many questions and debates about definitions of concepts, analytical strategies, interpretation of findings, and explanatory models. 1- 10 Any glossary for health inequalities therefore must go further than simply defining terms and concepts-it must also acknowledge and discuss controversies in the field. The following glossary is neither intended to be a comprehensive treatment of this subject, nor an exhaustive list of textbook definitions. Rather than adopting a purely definitional approach to health inequalities, we have chosen to highlight some major debates in contemporary research as a way of introducing key concepts and terminology in the field. Many of the issues we have selected to discuss are controversial simply because there are still large gaps in the scientific understanding of the determinants of health. Readers may take different views and disagree about the issues, partly because the science has not yet gone far enough and we are left to make informed guesses.
We focus on eight key questions pertinent to health inequalities: What is the distinction between health inequality and health inequity?
Should we measure health inequalities (that is, describing the distribution of health across individuals), or should we measure social group differences in health (for example, inequalities in health by social class)?
Do health inequalities mainly reflect the effects of poverty or are they generated by the socioeconomic gradient?
Are health inequalities mediated by material deprivation or by psychosocial mechanisms?
Is there an effect of relative income on health, separate from the effects of absolute income?
Do health inequalities between places simply reflect health inequalities between social groups or, more significantly, do they suggest a contextual effect of place in shaping inequalities in health?
What is the contribution of the life course to health inequalities?
What other kinds of inequality should we study?
THE DISTINCTION BETWEEN HEALTH INEQUALITY AND HEALTH INEQUITY
Inequality and equality are dimensional concepts, simply referring to measurable quantities. Inequity and equity, on the other hand, are political concepts, expressing a moral commitment to social justice.
Health inequality is the generic term used to designate differences, variations, and disparities in the health achievements of individuals and groups. A straightforward example of health inequality is higher incidence of disease X in...