The concepts and principles of equity and health

All the 32 member states in the World Health Organization European Region adopted a common health policy in 1980), followed by unanimous agreement on 38 regional targets in 1984. The first of these targets is concerned with equity. Target 1: “By the year 2000, the actual differences in health status between countries and between groups within countries should be reduced by at least 25%, by improving the level of health of disadvantaged nations and groups” (WHO, 1985a). In addition, equity is an underlying concept in many of the other targets. At present, the targets are being reassessed and revised, in particular moving away from a focus on physical health status as measured by mortality to encompass, wherever possible, many other dimensions of health and well-being. But still the underlying concept of equity in health has been judged to be just as important for the 1990s as it was when the programme began (WHO, 1985b). However, it has not always been clear what is meant by equity and health and this paper sets out to clarify the concepts and principles. This is not meant to be a technical document, but one aimed at raising awareness and stimulating debate in a wide general audience, including all those whose policies have an influence on health, both within and outside the health sector.