Framing Health Equity: US Health Disparities in Comparative Perspective

Area of Science:

• Public Health
• Health Policy Analysis
• Sociology of Health

Background:

• Health equity is a critical global health concern.
• Understanding national policy approaches to health equity is essential for targeted interventions.
• Previous research indicates variations in how countries conceptualize and address health disparities.

Purpose of the Study:

• To systematically analyze and compare conceptions of health equity in national health policy documents from the United States, United Kingdom, and France.
• To identify differences in the characterization of health inequalities and their theorized causes across these nations.
• To assess the extent to which policy documents advocate for structural changes to address root causes of health inequities.

Main Methods:

• Systematic review of key national health policy documents from the US, UK, and France.
• Qualitative analysis of document content focusing on definitions of health equity, identification of disparities (by SES, race/ethnicity, territory), and attributed causes of health inequalities.
• Comparative analysis across the three countries.

Main Results:

• Substantial cross-national differences were observed in how health equity is conceptualized.
• Characterizations of group differences and theorized causes of health inequalities varied significantly.
• While social determinants of health were minimally acknowledged as a cause, policy documents generally stopped short of recommending the necessary redistribution of power and resources.

Conclusions:

• National health policy documents in the US, UK, and France present distinct approaches to health equity.
• There is a consistent gap between acknowledging social determinants of health and advocating for the structural reforms needed to achieve health equity.
• Future policy recommendations should consider more robust strategies for addressing the root causes of health inequalities.