14.2 Health as a Human Right

Health as a human right is a cornerstone of public health ethics. This concept recognizes that everyone deserves access to quality healthcare, regardless of their background or circumstances. It's about fairness and equality in health outcomes.

The right to health goes beyond just medical care. It includes clean water, safe housing, and education. This broader view acknowledges that many factors outside the doctor's office impact our wellbeing. It's a holistic approach to health and social justice.

Fundamental Human Rights

Universal Declaration of Human Rights and the Right to Health

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• Universal Declaration of Human Rights (UDHR) adopted by the United Nations General Assembly in 1948
• UDHR establishes the fundamental rights and freedoms that all human beings are entitled to, regardless of race, gender, nationality, ethnicity, language, religion, or any other status
• Right to health is a fundamental human right recognized in the UDHR (Article 25)
• Right to health includes the right to access healthcare services, essential medicines, and the underlying determinants of health (safe drinking water, sanitation, food, housing, health-related education and information)

Access to Healthcare as a Human Right

• Access to healthcare is a critical component of the right to health
• Governments have an obligation to ensure that everyone has access to quality healthcare services without discrimination
• Access to healthcare includes the availability, accessibility, acceptability, and quality of healthcare services (AAAQ framework)
• Availability refers to the sufficient quantity of functioning healthcare facilities, goods, services, and programs
• Accessibility encompasses non-discrimination, physical accessibility, economic accessibility (affordability), and information accessibility
• Acceptability means that healthcare services must be respectful of medical ethics and culturally appropriate
• Quality requires that healthcare services are scientifically and medically appropriate and of good quality

Health Equity and Disparities

Health Equity and Social Determinants of Health

• Health equity is the absence of unfair and avoidable differences in health among population groups
• Health equity means that everyone has a fair opportunity to attain their full health potential, and no one is disadvantaged from achieving this potential because of their social position or other socially determined circumstances
• Social determinants of health are the conditions in which people are born, grow, live, work, and age that shape their health outcomes
• Social determinants of health include factors such as income, education, employment, housing, social support networks, and access to healthcare
• Addressing social determinants of health is crucial for achieving health equity and reducing health disparities

Health Disparities and Their Causes

• Health disparities are differences in health outcomes and their determinants between segments of the population, as defined by social, demographic, environmental, and geographic attributes
• Health disparities are often rooted in social and economic inequalities, such as poverty, discrimination, and lack of access to education and healthcare
• Examples of health disparities include higher rates of chronic diseases (diabetes, heart disease) among racial and ethnic minorities, and lower life expectancy in low-income communities compared to high-income communities
• Reducing health disparities requires addressing the underlying social, economic, and environmental factors that contribute to these inequalities
• Strategies to reduce health disparities include improving access to quality healthcare, promoting health education, and implementing policies that address social determinants of health (affordable housing, living wage, early childhood education)

Healthcare Systems

Universal Health Coverage

• Universal health coverage (UHC) means that all people have access to the healthcare services they need without suffering financial hardship
• UHC includes the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care
• UHC is a crucial component of sustainable development and poverty reduction, and a key element of any effort to reduce social inequities
• Achieving UHC requires a strong, efficient, well-run health system that provides the entire population with access to quality healthcare services, health workers, medicines, and technologies
• Financing for UHC should be through mandatory funding (taxes or insurance contributions) that ensure people do not suffer financial hardship when using healthcare services

Access to Healthcare in Different Healthcare Systems

• Access to healthcare varies depending on the type of healthcare system in a country
• In countries with universal healthcare systems (United Kingdom, Canada), healthcare is publicly funded and available to all citizens and legal residents
• In countries with a private healthcare system (United States), access to healthcare is largely dependent on having private health insurance, which can be expensive and leave many people uninsured or underinsured
• Countries with mixed healthcare systems (Australia, France) have a combination of public and private healthcare, with the government providing a basic level of coverage for all citizens and private insurance available for those who want additional coverage
• Regardless of the type of healthcare system, ensuring access to quality healthcare services for all individuals is essential for achieving health equity and fulfilling the right to health