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Health inequality|Social inequality is "fatal". Who needs to be responsible for personal health?

2021-11-24T12:12:21.353Z


"Health inequality" is a concept that is difficult to attract everyone's attention, because for many people, "health" is their own business, while "inequality" refers to social status and resource distribution. There seems to be nothing between the two.


"Health inequality" is a concept that is difficult to attract everyone's attention, because for many people, "health" is their own business, while "inequality" refers to social status and resource distribution. There seems to be nothing between the two. Relevance; however, "health inequality" is a real problem that seriously threatens different classes.

"Fatal Inequality: How Social Injustices Threat Our Health" by Michael Marmot, Professor of Epidemiology at University College London and Co-Director of the Institute of Health Equity of the Chinese University of Hong Kong, uses years of empirical research to support "individuals". There is a correlation between "health" and "social status", and the first "Health Equity Report" published by the Institute of Health Equity of CUHK last Tuesday (November 16) also shows that social inequality will bring health Inequality.


Ma Mu, who has been engaged in "health inequality" research for more than 40 years, proposed a "social gradient" framework based on years of empirical data. He believes that social status and personal health have a positive relationship. The worse.

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According to the definition of the World Health Organization, "health" means "physical, psychological, and social comfort, not just a state of being free from disease or debilitating". This is one of the basic rights of an individual to survive.

The Charter of the World Health Organization clearly stated: "It is the basic right of everyone to enjoy the highest possible level of health regardless of race, religion, political beliefs, economic or social conditions." The 1948 Universal Declaration of Human Rights stated More specific explanation: "Everyone has the right to enjoy the standard of living required to maintain the health and well-being of himself and his family, including food, clothing, housing, medical care, and necessary social services." In 1978, the "Almaty Declaration" began to propose The idea of ​​"Integrating health into all policies" emphasizes that different government departments and social stakeholders should take "health" as the goal of social development, and the former should take "health" as the main consideration in formulating policies.

However, ideals are beautiful and reality is cruel, because most governments are reluctant to directly admit that personal health is affected by social factors, and it has not improved until recent years.

Ma Mu, who has been engaged in "health inequality" research for more than 40 years, proposed a "social gradient" framework based on years of empirical data. He believes that social status and personal health have a positive relationship. The worse.

He explained the concepts in detail in the latest Chinese edition of "Fatal Inequality: How Social Injustice Threaten Our Health".

Most people might think that the “social gradient” framework is more suitable for poor countries because of the lack of clean water, poor sanitation, and limited medical standards; however, even in developed regions, not everyone can enjoy abundance fairly. Materials and medical resources, so the degree of health is also different.

Mamu was invited by the British Minister of Health to conduct a "health inequality" survey in 2008. He published the "Mamu Report" two years later and put forward six policy goals: to give every child a good start to life; to make all children , Adolescents and adults can give full play to their strengths and control their lives; create fair employment and good job opportunities for all; ensure a healthy living standard for all; develop healthy and sustainable communities; strengthen disease prevention.

Hong Kong’s poor population reached 1.653 million last year, and the poverty rate reached 23.6%, a record high since 2009.

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The disparity between the rich and the poor in Hong Kong is extremely serious. Last year's GDP per capita exceeded US$40,000, ranking 15th in the world, but at the same time there are more than 1.65 million poor people, the highest since 2009.

Ma Mu is also very interested in the issue of "health inequality" in Hong Kong.

The Institute of Health Equity of the Chinese University of Hong Kong, where he works, published the first "Health Equity Report" in Hong Kong last Tuesday, pointing out that vulnerable communities such as new immigrants, ethnic minorities, and low-income families in Hong Kong are more likely to be delayed in diagnosis and treatment. And it is more susceptible to employment, education, economic security, health and the use of social services.

A common example is that people who live in an environment with insufficient resources and small space have poor health and will directly affect the next generation.

For example, Huang Yangshan, Dean of the School of Public Health and Primary Medical Care of the Jockey Club of the Chinese University of Hong Kong, has found in previous studies that people with poor housing affordability are more likely to develop greater psychological stress, which can lead to mental illness and physical adjustment overload, hormonal imbalance and cortisol Higher risk increases the risk of cardiovascular disease.

Since the social resources that the disadvantaged groups have direct access to are few, it stands to reason that they need the health support of the whole society more, but they often get the least.

Health inequality increases their chances of getting sick and causing poverty. Poverty makes it difficult for them to obtain necessary nutritional supplements and livable and comfortable living space. Poverty causes illness and hinders their further development.

The combination of various factors makes it more difficult for the grassroots to maintain a healthy standard of living.

The "Health Equity Report" also pointed out that the outbreak of the new crown virus in 2020 will undoubtedly exacerbate this inequality, because the economic environment is very different, the grassroots are more susceptible than the wealthy, and the health status is relatively worse.

Research by Zhong Yinuo, assistant professor of the School of Public Health and Primary Care at CUHK, explained that most of the health inequality related to the epidemic is more related to social life and economic activity factors other than medical care.

After all, with the advancement of medical science and the increase in public health knowledge, people’s health conditions have the opportunity to greatly improve, but health is not limited to medical treatment, because the medical system only accounts for 20% of a person’s health factor ratio, and socioeconomic factors such as Education level, income, community support, etc. account for as high as 40%.

The World Wealth and Income Database (WID) released this month's research report on the disparity between the rich and the poor in Hong Kong, which shows that in the past 40 years, the problem of income inequality in Hong Kong has become more and more serious.

According to the study, since the reunification, the total wages of people with the highest income of 1% in Hong Kong are higher than those of the lowest 50%, that is, they have more income in Hong Kong.

Unlike Hong Kong’s long-standing use of income as a single standard to establish a poverty line, Mamu believes that people in different socio-economic status will have different levels of needs. The government should allocate resources accordingly to respond to the different needs of different communities. , To give appropriate assistance to the poor, but this does not mean that health inequality is only related to what the government does. It requires the triangle of government, scholars, knowledge, and the community to put aside the idea that the poor are not worthy of health.

Source: hk1

All news articles on 2021-11-24

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