02 June 2021

How Health Inequalities Accelerates COVID-19

With prevalent health inequalities affecting communities worldwide, what are we doing to improve healthcare for those affected?

Health’ is defined as the state of complete physical, mental, and social well-being and the importance of it is undeniable. It’s a fundamental feature, significantly associated with all other aspects of life, whether we are conscious of its impacts or not.

Despite this, a life of adequate health is a reality not easily attained by everyone

As the recent pandemic has evidently highlighted, some people are capable of living healthier lives with greater access to healthcare compared to others, solely due to differences arising from the circumstances in which they are born into, work at, and live in. This is known as health inequality, characterised by preventable, unjustified differences in the level of health or in the distribution of health risks and resources between different people across the population.

Health inequalities are the result of complex interactions between various social determinants of health such as employment, access to food, decent housing, and social inclusion, to name a few. 

Take for example the African-American community of the United States, who represent a mere 13% of the total population, yet account for the highest proportion of HIV infections in the country. This is due to a lack of standardised health education in certain communities as well as deprived access to effective care and treatment, a factor that is largely dependent on an individual’s level of income.

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Here are several other factors that contribute to the persistent health inequalities seen in our world today:

1. Location

Access to safe environments, clean basic amenities, and good quality accommodation are important geographical aspects conducive to overall well-being and long life-expectancy

For example, a recent study observed a significant location-based health disparity in Malaysia as it found that a newborn in Kuala Lumpur can potentially live up to 7 years more than a newborn in Perlis, depending on the conditions in which the child lives and grows.

Currently, as we see a wide distribution of testing and vaccines for COVID-19 among urban communities, those residing in remote areas, located a significant distance away from district hospitals and clinics, are also prone to experiencing a lack of access to COVID-19 testing, treatment for diseases, as well as vaccine registration due to their location.


2. Income

The difference in individual wealth across the population is a primary factor in determining a person’s ability to access a quality livelihood. 

With recurrent occuring partial and full lockdowns in the past year, the substantial decrease in earnings and the loss of work has become the central issue of households across the country. For those at a lower socio-economic position, this also contributes to an active source of everyday stress that ultimately translates into a decrease in overall health and life expectancy. 

According to WHO, people from countries with a low average income have a potential life expectancy of 62 while those from high income countries can live up to 81 years. This issue is further exacerbated when gender inequality is put into play as the current gender pay gap of 16.3% increases the risk of women experiencing poverty as well as living longer years of ill-health in their lifetime compared to men.


3. Education

Latest study conducted in the Asia-Pacific region found that youth, aged 15-24 in Afghanistan have the lowest literacy rates compared to those from other countries across the region

To compound this problem further, the literacy rate of boys is found to be strikingly higher than that of girls, clearly demonstrating the lack of education provided to them due to discriminatory gender disparities. Not only does this lead to reduced awareness of good and bad health habits, but it also increases the risk of unemployment which in turn, extends to poor overall physical and mental well-being. 

In addition to this, inaccurate information from unreliable sources also lead to countless myths, fears, and widespread panic in matters related to the coronavirus, its treatment, as well as vaccinations — all of which can be averted with ease by means of proper education.

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Even before the COVID-19 pandemic, the health inequalities threatening our reality today greatly hinders the progression and development of mankind as a people. 

We simply cannot prosper equally in a world where one person thrives while thousands of others suffer unjustly. However, by undertaking the appropriate measures, there’s still hope to overcome this pressing state of inequality. Here’s how we can work towards achieving this:

1. Policies

It’s imperative that government strategies approach the issue of inequality from its source – namely, in healthcare facilities, health resources, and its manner of distribution to the general public. 

Health policies that exclude certain people or communities (often unintentionally) should be recognised, modified, and regularly evaluated to ensure they remain relevant and effective to the needs of the community.

Apart from this, other policies that indirectly translate into improved health conditions should also be implemented. These include early childhood development schemes, unrestricted access to education, as well as comprehensive social protection policies that encompass the provision of basic utilities such as environmental sanitation, electricity, and sustainable housing.


2. Universal Healthcare

In order to successfully execute the notion of ‘healthcare for all’, it should be systematically planned on the basis of health equity, rather than health equality. 

This is due to the fact that health equality sets out to provide everyone with the same standard of health service, while health equity aims to ensure everyone receives personalised care based on their specific needs. This allows them to attain the same level of health as the rest of the population, despite their limitations imposed by the previously mentioned social determinants of health.

Here are some ways to jumpstart this initiative:

  • Direct focus on disease prevention and health promotion within communities

  • Provide low-cost services for individuals from low-income households

  • Mobile health screenings for those without transportation

  • Global health surveillance systems for routine monitoring of preventable diseases and to evaluate the effectiveness of health policies


3. Health Empowerment

There’s no force that inspires greater change than a well-informed community seeking control over the issues and decisions affecting their health and their lives. Health empowerment aims to achieve this through education, inclusive decision-making with healthcare officials, as well as encouraging patient self-management by means of health coaching and community-based support.


Health inequalities are found to be highly prevalent and consistently impacting the lives and well-being of people and communities across the globe. With this in mind, the rational course of action would be to acknowledge the current issue of health inequality, to understand the extent to which it affects our society, and finally, to take the appropriate measures to tackle the situation effectively. 

This is when extensive understanding of the social determinants of health and stronger emphasis on public health research is required to ensure everyone has access to quality health services whenever and wherever they need them.

Health inequalities contradict the very principles of social justice that govern our society today. Therefore, it’s crucial that governments, public and private healthcare departments, and communities across the world are adequately financed, utterly committed, and aptly capable to come together and be part of the solution in bringing about positive, long-lasting change to our healthcare system. 

Thus, overcoming the issue of health inequality.

Daeshnaa is currently pursuing her Bachelor of Medicine, Bachelor of Surgery (MBBS) at Taylor's University. She also enjoys writing, baking and spending time with family.

Guest Contributor