Health inequities in India by socio-economic position

Abstract

Health inequities in India along socio-economic axis are relatively more studied among the different axes of health inequities. In this chapter, we present a synthesis of literature on India on inequities in health by socio-economic position. We begin with a discussion on the historical origins of research on socio-economic inequity in industrialised settings. These initial revelations on social patterning of illnesses (illness profiles) spurred efforts to categorise and describe these population differences on one hand as well as theorise and explain (or predict) why these differences are pervasive in societies on the other. We then summarise current knowledge on socio-economic inequities in health drawing from a synthesis of published literature. In the final section, we discuss how current research on socio-economic inequities can help us understand the possible pathways and mechanisms through which such inequities are mitigated, maintained or aggravated. There are clear patterns of socio-economic disadvantage with respect to healthcare seeking and access across the country albeit showing differences within and across states. This general pattern is seen across populations, services (maternal and child health, immunisation, nutrition, anaemia and various other health problems) and geographies, and mirrors a global disadvantage faced by the poor. However, the possible mechanisms through which these are brought about and/or sustained are based on an interaction between and within various other axes of inequity including caste, gender and other social disadvantages. The Commission on Social Determinants of Health framework is useful to organise explanations for recurring themes that emerge across the research on socio-economic inequity in India. Some of the explanatory mechanisms that emerge from the themes discussed in papers on socio-economic inequity are described.