Socio-economic inequality and its effect on healthcare delivery in India

Milind Deogaonkar, MD Department of Neurosciences Cleveland Clinic Foundation Cleveland, OH USA

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Abstract

Social and economic inequality is detrimental to the health of any society but especially when the society is diverse, multicultural, overpopulated and undergoing rapid but unequal economic growth. This paper attempts to review the effects of growing socio-economic inequality in Indian population and its effect on the healthcare system. It tries to identify the factors responsible for the difficulties in healthcare delivery in an unequal society and its effect on the health of a society.

Background

“In the beginning, there was desire which was the first seed of mind,” says Rig-Veda, which probably is the earliest piece of literature known to mankind. This desire for a healthy family, healthy society and a healthy country drives individuals and governments alike. The government is supposed to create settings that will provide equal opportunity for an individual to fulfill these desires. There is an undisputed association between this social equality, social integration and health. The effect of social integration on health is conclusively documented in the theory of ‘social support’¹ . The effect of social and economic inequality on health is profound too. Poverty, which is a result of social and economic inequality in a society, is detrimental to the health of population. The outcome indicators of health (mortality, morbidity and life expectancy) are all directly influenced by the standards of living of a given population. More so, it is not the absolute deprivation of income that matters, but the relative distribution of income² . Various international studies have documented a strong association between income inequality and excess mortality^{3 4} . In a study by Kennedy et al, income inequality was shown to directly affect the total mortality in a given population [p