health inequities

I’ve been struggling to understand the usage of the word “inequity” and its difference from “inequality”, at least for the past several hours. I found it in WHO website, and WHO defines “inequity” in its Glossary section.

Health inequalities can be defined as differences in health status or in the distribution of health determinants between different population groups. For example, differences in mobility between elderly people and younger populations or differences in mortality rates between people from different social classes. It is important to distinguish between inequality in health and inequity. Some health inequalities are attributable to biological variations or free choice and others are attributable to the external environment and conditions mainly outside the control of the individuals concerned. In the first case it may be impossible or ethically or ideologically unacceptable to change the health determinants and so the health inequalities are unavoidable. In the second, the uneven distribution may be unnecessary and avoidable as well as unjust and unfair, so that the resulting health inequalities also lead to inequity in health. (http://www.who.int/hia/about/glos/en/index1.html)

I’ve been thinking, under this evening drizzle when I went home from ELTI, that some inequities actually happened around me that made me decide not to become a practicing physician, which can be considered as health inequities.

On one side, doctors are being put in the spotlight (or perhaps cornered) by giving them heavy penalties, and treated as criminals, if they make mistakes which often are not because of bad intention. The common people also tend to be the “wise guy” by giving negative comments about doctors, like “doctors are late to see patients because they’re busy having business lunch or playing golf” which is sometimes are not correct. In my country, some doctors that work in remote areas as a non permanent employee (including those who are doing their internship) tend to receive their salary several months late. I also have friends working in certain remote area, and they’re very helpful and understanding for their patients, to the extent of giving their patients money to check themselves to a larger hospital.

On the other hand, I have also met or heard about some doctors that ignore their patients’ needs, blatantly charging patients with expensive costs for a not-so-much-of-a-service, “changing vulva into volvo (cars)” -a satire common among obstetricians, and many examples. They don’t give benefits except to themselves. They merely collect money from patients, which some are poor patients, for their own sake.

Can both cases be regarded as inequities? They might not really health inequities as expressed by WHO, but for me, they are inequities in health .

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