In the first part of his article, Braveman (2006) discusses the terms “health inequalities,’ “health disparities,” and “health equity,” looking at Margaret Whitehead’s definitions of each as were applied in the 1990’s, the first time a “concise and accessible definition of health disparities/inequalities/equity was articulated” (p. 2). He provides tables that break down definitions and parameters of health inequalities/disparities/equity formulated by others and examines the methodologies used to determine these parameters (pp. 5, 7-11). Many of these previous definitions depend on measurements based on social position, “relative advantage and disadvantage in social hierarchies,” or on “particular kinds of comparisons that should be made between/among groups with different social positions” (p. 14), i.e., ethnic, cultural, gendered positions. Braveman (2006) indicates that there is need for a definition that considers the implications of both and introduces his own proposed definition and parameters for these terms, explaining his reasons for the changes, the values that underlie those reasons, and how the definition change contributes something new to our understanding of the terms. The main point of the article overall is that there is a need for change in the way we understand the concepts of health inequalities/disparities/equity, especially here in the United States. His reasons are two of the most surprising aspects of this article: first, that there currently is no consensus among sociologists, health professionals, or policy makers on the definitions of health inequalities/disparities/equity. Policy can determine “which measurements are monitored by national, state/provincial, and local governments and international agencies, but also which activities will receive support from resources allocated to address health disparities/inequalities and health equity,” and because a consensus is necessary for creating policies that can effect changes in health, it is startling that one unanimously-agreed-upon definition is nonexistent. Second, while most of Europe understands and acts on these concepts based on socioeconomic inequalities, here in the Unites States, we understand them based primarily on racial/ethnic inequalities, and because the two often go in hand, we need a definition that adequately measures both. Braveman (2006) points out that most of us have an understanding of human rights as political and civil ones but “human rights also encompass economic, social, and cultural rights, such as the right to a decent standard of living, which in turn encompasses rights to adequate food, water, shelter, and clothing requisite for health, as well as the right to health itself,” and because “almost every country in the world has signed one or more agreements that include important health-related rights” (p. 17), it is vital that the world powers come to an agreement on how to define these terms in order to create policies and allocate resources that address them.
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