CDE Appendix 1 Literature Review - Central East Local Health ...
CDE Appendix 1 Literature Review - Central East Local Health ...
CDE Appendix 1 Literature Review - Central East Local Health ...
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The Culture, Diversity and Equity Project: <strong>Literature</strong> <strong>Review</strong><br />
Box 4.7: Examples of health policy targets relating to inequalities in health<br />
NHS London Strategic Plan 2008-2013 [UK]<br />
Target 1: Average life expectancy of Londoners increased by at least 2 years for males and females.<br />
Target 2: Number of primary care clinicians per population to increase as a function of deprivation so that the most deprived<br />
boroughs have more primary care clinicians.<br />
Target 3: The difference in life expectancy between the best and worst boroughs in London is reduced by 10 per cent.<br />
Source: NHS London, 2008.<br />
The WHO Commission on Social Determinants of <strong>Health</strong> Closing the Gap (2008)<br />
Target 1: Reduce by 10 years, between 2000 and 2040, the LEB [Life Expectancy at Birth] gap between the one third of<br />
countries with the highest and the one third of countries with the lowest LEB levels, by levelling up countries with lower LEB.<br />
Halve, between 2000 and 2040, the LEB gap between social groups within countries, by levelling up the LEB of lower<br />
socioeconomic groups.<br />
Target 2: Halve, between 2000 and 2040, adult mortality rates in all countries and in all social groups within countries. In effect,<br />
achieving this target means reducing the gap in adult mortality between and within countries by half.<br />
Target 3: Reduce by 90%, between 2000 and 2040, the under-5 mortality rate in all countries and all social groups within<br />
countries, and reduce by 95%, between 2000 and 2040, the maternal mortality rate in all countries and all social groups within<br />
countries. In effect, achieving this target means reducing the gap in under-5 mortality between and within countries by 90%, and<br />
reducing the gap in maternal mortality between and within countries by 95%.<br />
Source: WHO, 2008<br />
<strong>Health</strong> 21 – <strong>Health</strong> for All in the 21 st Century [WHO]<br />
Target 2 – Equality in <strong>Health</strong><br />
By the year 2020, the health gap between socioeconomic groups within countries should be reduced by at least one fourth<br />
in all Member States, by substantially improving the level of health of disadvantaged groups.<br />
In particular:<br />
*the gap in life expectancy between socioeconomic groups should be reduced by at least 25 per cent;<br />
*the values for major indicators of morbidity, disability and mortality in groups across the socioeconomic gradients should be<br />
more equally distributed;<br />
*socioeconomic conditions that produce adverse health effects, notably differences in income, educational achievement and<br />
access to the labour market, should be substantially improved;<br />
*the proportion of the population living in poverty should be greatly reduced; people having special needs as a result of their<br />
health, social or economic circumstances should be protected from exclusion and given easy access to appropriate care.<br />
Source: WHO, 1999<br />
Ongoing Monitoring & Assessment<br />
<strong>Health</strong> equity policy performance indicators and targets need not only be developed, but also consistently monitored<br />
and reported on an ongoing basis, in order to ensure accountability and the intelligent (on the basis of evaluation<br />
evidence) steering and review of policy objectives and strategic interventions. As Exworthy et al. stress,<br />
policymakers “need to demonstrate the progress of their policies in order to sustain their momentum and to promote<br />
accountability” (2006, p.76).<br />
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