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The fair social distribution of valuable health care resources is a coher-
ent concern, and speaks to the question of how nations should allocate
resources during a pandemic. But concerns about equity or fairness
have also been raised regarding the high proportion of deaths among
older people and racial and ethnic minorities, the impacts of lock-
downs and gender inequalities, and the economic impacts due to loss
of incomes and jobs. Beyond the allocation of health care resources,
the equity concerns raised by this pandemic go to the very founda-
tions of how the 260-plus countries and territories in the world are
organized and function.
Health Equity and Social Determinants of Health
During normal times, the health and well-being of both individu-
als and a national population, as well as health inequalities across
individuals and social groups, are created overwhelmingly by social
determinants. Across all high-, middle-, and low-income countries,
social determinants of health are what have been described as “the
conditions in which people are born, grow, live, work and age.”3
These conditions include such things as early infant care and stimula-
tion, safe and secure employment, housing conditions, discrimination,
self-respect, personal relationships, community cohesion, and income
inequality, among others. Access to health care for prevention and
care is important, but it is only one of the many social determinants of
health, illness, impairments, and premature death. Furthermore, these
determinants operate at levels ranging from the micro, such as inter-
personal interactions affecting neuropsycho-biological pathways, to
the meso and macro, such as community cultures, national political
regimes, and global processes affecting trade—and, as this pandemic
shows, global organizations, governance structures, and norms.
Social determinants of health, unlike the proximate determi-
nants of individual biology, personal behaviours, and exposure to
harmful agents (for example, pathogens) are most often the long chain
of causes setting up these proximate determinants. A third key aspect
of social determinants of health is that health, with life expectancy
3. WHO Commission on Social Determinants of Health & World Health
Organization, “Closing the Gap in a Generation: Health Equity Through Action
on the Social Determinants of Health: Final Report of the Commission on Social
Determinants of Health” (2008), online (pdf): World Health Organization <www.
who.int/social_determinants/final_report/csdh_finalreport_2008.pdf>.
VULNERABLE
The Law, Policy and Ethics of COVID-19
- Title
- VULNERABLE
- Subtitle
- The Law, Policy and Ethics of COVID-19
- Authors
- Vanessa MacDonnell
- Jane Philpott
- Sophie Thériault
- Sridhar Venkatapuram
- Publisher
- Ottawa Press
- Date
- 2020
- Language
- English
- License
- CC BY-NC-ND 4.0
- ISBN
- 9780776636429
- Size
- 15.2 x 22.8 cm
- Pages
- 648
- Categories
- Coronavirus
- International