Structural drivers of inequities in health

Abstract

This introductory chapter provides the backdrop against which the evidence on health inequities in India, synthesised in later chapters, may be understood. In this chapter, we argue that the extreme economic inequalities underlying significant inequities in health are fuelled by forces of neo-liberal globalisation. The chapter illustrates with facts and figures that the neo-liberal economic policies that were adopted in India since the mid-1980s have increased income and wealth inequalities. While economic growth has been significant, the benefits have not accrued to those in the lowest income and wealth categories. Growth has not generated adequate employment to absorb the surplus rural labour or the new entrants into the labour force. A large proportion of workers experience insecure livelihoods and poor living and working conditions. These adversities are experienced disproportionately by those already disadvantaged based inter alia on class, caste and gender, and may be expected to impact the pattern of inequities in health in India.