Excerpt directly from Achieving Equity in Health Outcomes: Highlights of important national and international papers. Ministry of Health (2018). Achieving Equity in Health Outcomes: Highlights of important national and international papers. Wellington: Ministry of Health.
https://www.health.govt.nz/publication/achieving-equity-health-outcomes-highlights-selected-papers
The concept of equity in health is an ethical principle, closely related to human rights, in particular, the right of all humans to experience good health. The WHO constitution states this right; international human rights treaties, such as the 1948 Universal Declaration of Human Rights, state that people have the right to ‘the highest attainable standard of health’. The highest attainable standard of health is a reflection of the standard of health enjoyed in the most socially advantaged group within a society. This indicates a level of health that is biologically attainable and the minimum standard for what should be possible for everyone in that society.
The right to health can be interpreted as governments providing equal opportunities to all people to be healthy, meaning that all people attain the highest possible level of mental and physical wellbeing. According to human rights principles (OHCHR 2008), all human rights are considered inter-related and indivisible. The right to good health cannot be separated from other rights, including the rights to a decent standard of living and education as well as freedom from discrimination and freedom to participate fully in society.
While equity and equality are distinct, it is necessary to understand the concept of equality in order to measure and instigate health equity. Equality can be described as the state of being equal, especially in terms of status, rights or opportunities. The Health Quality and Safety Commission considers it is important to distinguish between equality and equity (Poynter, et al., 2017). Equality is ‘sameness’, while equity is an ethical construct that recognises that different groups may require different approaches and resources to achieve the same outcomes. Uniform approaches are indeed equal because they provide the same care to every person. However, uniform approaches become inequitable (unfair) as soon as there are differences between groups. Uniformity fails to account for the contextual differences between people, such as age, gender, ethnicity, socioeconomic status, disability, number and severity of health conditions, as well as access to primary health care among others.
Equity in health implies resources are distributed and processes are designed in ways most likely to equalise the health outcomes of disadvantaged social groups with the outcomes of their more advantaged counterparts. While this encompasses the distribution and design of health care resources and programmes, all resources, policies and programmes play a part in shaping health, many of which are outside the immediate control of the health sector.
