Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 Articles
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2022
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 Articles
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2022
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Letters

Social and economic justice: the road to health

Sonal Singh
CMAJ October 26, 2004 171 (9) 1021; DOI: https://doi.org/10.1503/cmaj.1040922
Sonal Singh
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Responses
  • Metrics
  • PDF
Loading
  • © 2004 Canadian Medical Association or its licensors

I disagree with Prabhat Jha and James Lavery1 that technological advances, rather than improvements in income and education, have been responsible for improvements in health care in the developing world.

Sri Lanka and the state of Kerala in India have made rapid advances in health care through their investment in primary care and education and measures to reduce social and health inequities. Despite a civil war, Sri Lanka has the best health indicators in South East Asia, with average life expectancy of 73 years, infant mortality of 16 per 1000 and maternal mortality of 30 per 100 000 live births.2 This country does not have a single MRI scanner in the public sector, which highlights an emphasis on primary care. Similarly, Kerala has achieved health and demographic indicators far ahead of Indian national averages.2

The greatest health hazard is in fact the economic gap between the rich and the poor. According to population health studies, the primary determinant of health within a country is societal structure, especially the degree of hierarchy as measured by income distribution.3 Not only is the health of a population related to income, but at any given level of overall economic development for a country or a region within a country, the populations of countries and regions with smaller gaps between rich and poor are, in general, healthier than the populations of countries and regions where the gap is larger.4 A case in point is the United States, which spent the most on health care but ranked only 26th in life expectancy in 2003; Japan was the top country in this ranking.5 Among the developed countries, the United States has the greatest gap between rich and poor, whereas Japan has the smallest gap.

The road to health for developing countries lies not in blindly emulating the West in terms of sophisticated medical care but in making sound investments in primary care and education as well as promoting social and economic justice.

Sonal Singh Unity Health System Rochester, NY

References

  1. 1.↵
    Jha P, Lavery JV. Evidence for global health [editorial]. CMAJ 2004;170(11):1687-8.
    OpenUrlFREE Full Text
  2. 2.↵
    Bhutta Z, Nundy S, Abbasi K. Is there hope for South Asia? [editorial]. BMJ 2004;328(7443):777-8.
    OpenUrlFREE Full Text
  3. 3.↵
    Bezruchka S. Societal hierarchy and the health Olympics [editorial]. CMAJ 2001;164(12):1701-3.
    OpenUrlFREE Full Text
  4. 4.↵
    Van Doorslaer E, Wagstaff A, Bleichrodt H, Calonge S, Gerdtham UG, Gerfin M, et al. Income-related inequalities in health: some international comparisons. J Health Econ 1997; 16 (1): 93-112.
    OpenUrlCrossRefPubMed
  5. 5.↵
    Population Health Forum. U.S.A. richest nation. Big gap civilization. Sickest population [online]. Seattle: University of Washington, School of Public Health and Community Medicine; 2003. Available: http://depts.washington.edu/eqhlth/index.htm (accessed 2004 Sept 09).
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 171 (9)
CMAJ
Vol. 171, Issue 9
26 Oct 2004
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Social and economic justice: the road to health
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Social and economic justice: the road to health
Sonal Singh
CMAJ Oct 2004, 171 (9) 1021; DOI: 10.1503/cmaj.1040922

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Social and economic justice: the road to health
Sonal Singh
CMAJ Oct 2004, 171 (9) 1021; DOI: 10.1503/cmaj.1040922
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
    • References
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Final consent, advance consent and alleviating suffering in frail adults requesting MAiD
  • Should physicians rethink travel to conferences?
  • Leveling the playing field in long-term care
Show more Letters

Similar Articles

Collections

  • Topics
    • Global health
    • Public health

 

View Latest Classified Ads

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Advisory Panels
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions
  • Accessibiity
  • CMA Civility Standards
CMAJ Group

Copyright 2022, CMA Impact Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: cmajgroup@cmaj.ca

Powered by HighWire