The slogan on the Global Health Africa website reads “Health is Wealth” but “Wealth is also Health”. By wealth I mean various resources -power, education, employment, inheritance, living conditions-which gives one individual an advantage over another. Possession of any of these resources increases one’s likelihood of a better health. A number of researchers have written about the influence of these socio-economic factors on one’s health; most notably, Michael Marmot. Below we discuss the link between these factors and health as well as implications for organizational policy.
Exploring the link between Wealth and Health
In his article published in a 2005 edition of the Lancet, Marmot provides an apt description of the variation in health outcomes within countries, by socio-economic status. Using Indonesia, Brazil, India and Kenya as examples, under-5 childhood mortality was shown to be highest among the poorest households in all these countries. While in Bangladesh, mortality rate among men differed by educational status
As a result, Marmot warns that addressing surface public health issues may not be the solution. Rather, there is a need to identify the causes of causes by examining the social conditions in which individuals live and work. Still, I am not in full agreement with his suggested methods for addressing these social conditions as they comprise of policies such as cash transfer programmes, which may encourage dependency on government welfare and are largely, unsustainable.
A recent example of health inequalities between nations can be seen in the newly released Global Burden of Disease Study 2010 by the Institute for Health Metrics and Evaluation in Seattle, Washington. Wealthy Western and Asian countries have the longest years of healthy life expectancy while some of the poorest African Nations are at the bottom of the ladder. So the question is: How can public health organizations address these health inequalities in Africa?
Changing the way we work
There is no one size fits for addressing health inequalities in Africa neither do I claim to know it all. Still, I make some suggestions.
- People empowerment approach rather than a people giving approach: A widely used proverb goes, “Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime”. Governmental and non-governmental public health organizations need to recognize that ill-health and premature death is often times a symptom of social conditions. Therefore, in planning public health interventions, it is pertinent to include measures that will aid individuals to acquire skills needed for self subsistence. This could include training breadwinners on business skills, providing loans for start-ups, as well as scholarships.
- Targeted interventions: This would ensure that the poorest of the poor have access to health information and services, education and an opportunity for their voice to be heard
- Working together: It is imperative that public health and non-public health organization work together to ensure that there is a focus on community priorities rather than organizational agenda
- Research and Advocacy: A lot of work still needs to be done to identify best practices for addressing health inequalities in African nations. There is also a need for organizations to advocate for policies that address the needs of the poorest of the poor in African Nations.
So what do you think? How best can health inequalities in Africa be addressed?