4 barriers to health equity - and how to overcome them

As populations expand and age, the number of working-age adults with a long-term health condition or disability is on the rise. And the prognosis and opportunities available to these people can vary significantly, with geography, gender, race, wealth and education level all among the influencing factors.

On top of this, the pandemic has laid bare many inequities in our healthcare systems - and made many worse.

This unequal access to healthcare and health outcomes also has a significant impact on economic equity. Research frequently links poor health with reduced economic productivity, loss of taxes - as well as poorer quality of life.

Here are four areas holding back progress on health equity.

The data we use to base our medical and healthcare decisions on is frequently biased. Clinical trial data, for example, has an acknowledged gender bias with women often excluded from research cohorts. There are also issues with an under-representation of non-white people in research.

As big data and AI become more prevalent in healthcare, there are concerns these biases could be exaggerated, or new biases introduced. These gaps in data and evidence generation affect the ability to identify priority areas for funding, deliver outcomes-based care and raise awareness of issues.

The World Economic Forum’s Global Health and Healthcare Report highlights the importance of putting a focus on diversity and creating clear guidelines for increasing inclusion.

Ageing populations, unhealthy habits and an increase in non-communicable diseases means health, in general, is on the decline. The extent to which this decline is felt differs depending on geography and demographics. This has a significant impact on the ability of countries to create resilient healthcare systems and equitable access to health.

Prevention and earlier diagnosis is increasingly important, with investments in these areas seen as vital to improving baseline health. This includes engaging people in healthcare education at an earlier stage. For example, vision care can be linked to prediction and early identification of diseases and conditions such as high blood pressure, diabetes and heart disease.

There is expected to be a 10 million shortage of healthcare workers by 2030, which will be particularly acute in low and middle-income countries. This is made worse by a trend of physicians migrating to richer countries in search of better working conditions and career opportunities.

The pandemic has also caused an epidemic of burnout, illness and mental health issues among healthcare workers which feeds into worker shortages.

With many countries’ healthcare systems struggling after the height of the pandemic, finding ways to create meaningful and rewarding careers for healthcare workers is a priority.

About three billion people do not have an internet connection, ruling them out of many of the digital innovations that patients elsewhere are starting to see. And many of those who are connected still have issues relating to cloud storage and bandwidth, particularly in poorer countries.

While the digitisation of healthcare has empowered some people, it risks leaving others behind and may exacerbate disparities. It is important that digital solutions are compatible for use in communities with limited digital infrastructure.

Where new technologies are being rolled out more widely, it is also important to ensure that quality of care is maintained.

“Health is a product of social determinants, including where one lives and works, and health and healthcare inequity continues to be a pressing issue,” says Shyam Bishen, Head of the Centre for Health and Healthcare at the Forum. “There are still geographic and demographic disparities in access to not only healthcare but high-quality healthcare.”

“The WHO has reported that over half of the world’s population lacks access to the basic health services they need. We also know the pandemic had a disproportionate impact on certain populations, highlighting inequities. The Centre for Health and Healthcare is working to solve for equitable access to determinants of health, ensuring people with equal needs achieve equal health outcomes around the world.”

Equitable access and outcomes are a key priority of healthcare reform as governments around the world look to creating systems fit for future demands. The Global Health and Healthcare Report highlights the importance of the public and private sectors working together to tackle health inequities, and this collaboration will be a core topic at the Forum’s Growth Summit in May.

It also makes clear that health inequity goes beyond a societal goal - there is a business incentive for employers to support their employees’ health and well-being as poor health leads to greater absences and a reduction in productivity. This is even more pressing in the current economic environment, which, as the Forum’s latest Chief Economist Outlook demonstrates, continues to present uncertainties and remains unpredictable for businesses.