Social inequality is the unequal distribution of resources, opportunities, and outcomes among different groups of people in society. It can be based on factors such as income, education, gender, ethnicity, religion, or caste. Social inequality can have significant impacts on the health and well-being of individuals and communities, especially at the apex of society, where the most privileged and powerful groups reside.
Contents
The Health Gap Between the Rich and the Poor
One of the most evident manifestations of social inequality is the health gap between the rich and the poor. According to WHO, there are wide disparities in the health status of different social groups in all countries, regardless of their level of development. The lower an individual’s socio-economic position, the higher their risk of poor health. For example, in India, children from the poorest 20% of households are nearly twice as likely to die before their fifth birthday as children in the richest 20%. Similarly, women in Chad have a lifetime risk of maternal death of 1 in 16, while a woman in Sweden has a risk of less than 1 in 10 000.
The health gap between the rich and the poor is not only a matter of access to health care, but also a result of the social determinants of health, which include the conditions in which people are born, grow, live, work, and age. These conditions are influenced by factors such as income, education, employment, housing, sanitation, nutrition, environment, and social support. The more unequal these conditions are, the more unequal the health outcomes are.
The Health Consequences of Being at the Top
While being at the top of the social hierarchy may seem to confer many advantages in terms of health and well-being, it also comes with some costs and challenges. Being at the apex of society often means having high levels of stress, pressure, competition, and responsibility. These factors can negatively affect mental and physical health, leading to problems such as anxiety, depression, burnout, cardiovascular disease, obesity, diabetes, and substance abuse.
Moreover, being at the top of society may also entail being isolated from other social groups and having less social cohesion and trust. According to Inequality.org, high levels of inequality reduce social cohesion and increase fear and insecurity for everyone. This can have adverse effects on health by weakening social support networks, increasing violence and crime rates, reducing civic participation and social capital, and undermining democratic institutions and values.
The Need for Social Justice and Universal Health Coverage
The relationship between social inequality and health is complex and multidimensional. It affects not only individuals but also societies as a whole. It hampers human development, economic growth, social stability, and environmental sustainability. It also violates human rights and dignity.
Therefore, there is an urgent need for addressing social inequality and promoting social justice in order to improve health outcomes for all people. One of the key strategies for achieving this goal is to ensure universal health coverage (UHC), which means that everyone has access to quality health services without facing financial hardship. UHC is not only a matter of providing health care but also a matter of addressing the underlying social determinants of health.
According to Oxfam India, India’s public health system has been underfunded and understaffed for decades, resulting in poor health infrastructure and outcomes. The COVID-19 pandemic has further exposed and exacerbated these inequalities. Therefore, Oxfam India calls for increasing public spending on health to at least 2.5% of GDP by 2024-25; strengthening primary health care; ensuring free testing and treatment for COVID-19; expanding social protection schemes; and ensuring equitable distribution of vaccines.
By implementing these measures, India can move towards achieving UHC and reducing health inequities among different social groups. This will not only benefit the health and well-being of individuals but also enhance the social and economic development of the country.
