Bring Health Inequality To An End

Global environment is enormously changing in the recent years. Despite significant progress in global health over the decades, the socio-cultural stability of our planet’s life is largely disrupted by the anthropogenic environmental changes. Undoubtedly, such changes will have profound impacts on human health, and subsequently drive majority of the global burden of disease in future. Unfortunately, poor, vulnerable and socially marginalised populations continue to be at high risk and most affected at large. 

In the context of global economic instability, migration, geopolitical shifts, and intensifying climate change, the future of global health is a high priority development agenda. Because the demographic and epidemiological transitions are unevenly progressing, and the interconnectedness of the world is changing its socio-political landscape in the context of globalisation and capitalist world. 

Global understanding 

As we are experiencing global issues such as climate change, rapid urbanisation, rising income inequality, environmental degradation, anti-microbial resistance, all of these essentially require a global understanding and concerted multi-sector actions. The pandemic of COVID-19 is a potent reminder for concerted actions to urgently address emerging threats in global health security. Proactive strategic and progressive actions are needed to reduce the growing health risks and mitigate the impacts of events that endanger human health across geographical and international boundaries. In essence, overcoming the health inequalities is key to progress in global health. 

As evident, population mobility, environmental degradation, and the misuse of antimicrobials are disrupting the equilibrium of the microbial world. The pandemics like COVID-19, global warming, natural hazards and disasters such as earthquakes, floods, and landslides disrupt people’s overall health and social well-being by causing adverse social and economic impacts on individuals, families and communities. 

Given these realities, global health largely focuses on trans-national health issues and their wider determinants within and beyond health sector. Indeed, the global health research and practice are rich and vast as they cover evolutions from tropical medicine to public and international health, analysis of global burden of disease, epidemiological transition, socio-cultural, economic, ecological and political determinants of health. 

Additionally, global health essentially aims to explore the relationships between health and development, creeping impacts of globalisation, neo-liberalism, migration and climate change on human health. Towards this end, more emphasis is on emerging needs of inter-disciplinary coordination and collaboration to address wider global health issues that threat to human health and sustainable development at large. 

In an increasingly globalised world, we are persistently experiencing intersecting inequalities in accessing quality health care services. Persistent social, cultural, economic, geographical psychological and political inequalities are likely to have differential effects on populations in terms of age, gender, class and ethnicity. In different societies, it is crucial to explore people’s perceptions on etiology of diseases, health seeking behaviour, issues of social stigma and discrimination, as well as likely impacts on social vulnerability, stress, coping and resilience. It is also necessary to ensure the inclusiveness of global health systems that fosters more equitable health outcomes for culturally diverse societies. 

Indeed, human behaviours are socio-culturally diverse and complex. These greatly affect health outcomes at large. Therefore, it is necessary to explore the cognitive, social, cultural and environmental drivers and barriers that influence health-related behaviours. In this context, anthropological approaches to global health have expanding scope in terms of conducting innovative research on a variety of topical challenges in global health. 

Across the world, evidence suggests that global health problems and challenges are disproportionately affecting people who are particularly living in low- and middle-income countries. From COVID-19 pandemic to antimicrobial resistance and universal health coverage, anthropological approaches help critically analyse these issues and challenges at multiple levels. Drawing on theories and concepts from medical anthropology, sociology, economics, history and numerous other fields, the ethnographic research helps understand local realities and concerns in everyday life. 

Therefore, the anthropological approaches provide valuable insights into the global health issues, including the political economy of health and intersecting inequalities, cultural diversity, and social adaptations, as well as the study of multispecies ethnography. The anthropological contributions to global health are evident from the ethnographic studies around health inequities in different socio-political and cultural contexts. These approaches primarily aim to explore the social and cultural dimensions of disease-illness dichotomy, health systems governance, social justice and human rights.   

On the other side, ecosystem approach to health is largely based on the understanding that health outcomes emerge from interrelationships within social–ecological systems. This approach rests on principles of trans-disciplinarity, participation, gender, social equity, systems thinking and sustainability. The ethnographic research methods also help explore and better understand how human activities impact on the natural systems in a holistic approach.  

Medical pluralism

Moreover, anthropological scholarship in global health greatly offers deeper insights on medical pluralism, health inequalities, social injustice, and structural violence by engaging interdisciplinary efforts for improving health and social well-being of the people in and across the societies. The approaches help raise genuine issues and questions around the relevance of localising global health policies and practices. It is also equally important to critique how the politics of international health policies influence local health systems and practices in low- and middle- income counties. 

In this way, global health constitutes a new political space that demands study of population's health in the context of power relations across a range of agencies. From this perspective, anthropological approaches are instrumental in understanding how global economic and political processes are mediated by ideas, institutions, networks and local-global connections in different socio-cultural and political contexts. After all, the ultimate goal is to reduce health inequities and contribute to global efforts of harnessing sustainable human development. 

(Bhandari is a health policy analyst)