Wealth, equity and health care : A critique of a "population health" perspective on the determinants of health.
In this paper we examine the recent ascendancy of a « population health » perspective on the « determinants of health » in health policy circles as conceptualized by health economists and social epidemiologists such as Evans and Stoddart [Evans and Stoddart (1990) Producing health, consuming health care.
Social Science & Medicine 31 (12), 1347-1363]. Their view, that the financing of health care systems may actually be deleterious for the health status of populations by drawing attention away from the (economic) determinants of health, has arguably become the « core » of the discourse of « population health ».
While applauding the efforts of these and other members of the Canadian Institute for Advanced Research for « pushing the envelope », we nevertheless have misgivings about their conceptualization of both the « problem » and its « solutions », as well as about the implications of their perspective for policy.
From our critique, we build an alternative point of view based on a political economy perspective.
We point out that Evans and Stoddart's evidence is open to alternative interpretations-and, in fact, that their conclusions regarding the importance of wealth creation do-not directly reflect the evidence presented, and are indicative of an oversimplified link between wealth and health. (...)
Mots-clés Pascal : Inégalité, Equité, Santé, Accessibilité, Soin, Système santé, Facteur risque, Aspect social, Aspect économique, Homme, Article synthèse
Mots-clés Pascal anglais : Inequality, Equity, Health, Accessibility, Care, Health system, Risk factor, Social aspect, Economic aspect, Human, Review
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0163613
Code Inist : 002B30A01B. Création : 21/07/1998.