Governance, regulation and health equity

Abstract

Whatever your beliefs about society, your political views, your outlook on life or your material circumstances, the enjoyment of adequate health is vital to the pursuit of whatever life you have reason to value. Health is intrinsic to living—no matter what one’s walk of life. But health is not simply an instrument for the purposes of other social functions; it is an end in itself. Health is the product and reflection of society’s attention to an adequate standard, available to all, in the conditions in which its population lives. In spite of impressive initiatives by institutions worldwide, health issues are constantly in the news: famines, wars, early death and escalating healthcare costs from obesity, diabetes, cancers and mental illness, deaths and injuries from traffic accidents and extreme weather events, and the prevailing communicable disease killers such as malaria, tuberculosis and now Ebola keep the world busy (AP-HealthGAEN 2011; Frieden et al. 2014; Murray et al. 2012). No country is immune from these concerns but such life and death experiences are not distributed evenly between or within nations. It seems remarkable that, today, a man living in the east end of Glasgow, where this author is from, is at risk of dying 15 years earlier than a man living in the west end of Glasgow (GCPH 2014). Within a prosperous country such as Australia, is it fair that the poorest 20 per cent of the population can still expect to die younger (six years, on average) than the richest 20 per cent of the population (Leigh 2013), and that those who are more socially disadvantaged (by income, employment status, education) and Indigenous Australians also have a higher risk of depression, diabetes, heart disease and cancers (AIHW 2015)? People born in Papua New Guinea die, on average, 21 years earlier than people born in Australia (WHO