Widespread disparities in health exist, but measuring inequality in outcome cannot explain why these disparities arise and persist—or show us how to tackle them. This is why Economist Impact, supported by Haleon, created the Health Inlusivity Index.
The Index defines health inclusivity as the removal of the personal, social, cultural and political barriers that prevent individuals and communities from experiencing good physical and mental health—and a life fully realised. To perform well in the Index a country must value health so highly that it pervades all areas of policy. The driving force behind the Index is the recognition that health is primarily generated outside of the healthcare sector.
Findings from the Index show that money is not the only driver of inclusivity. In fact, it may be the other way around: that better inclusivity can drive economic growth. How is this so?
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We found that a country’s wealth and health spending does not guarantee greater inclusivity in health—inclusivity is only somewhat related to GDP per capita or current health expenditure. When plotting Index score against financial investment in health, there is a lot of “scatter” either side of the line.
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Conversely, wealth comes from a healthy workforce. We found a positive relationship between Index scores and healthy life expectancy. This is important, because while global life expectancy has increased, healthy life expectancy has not–meaning that people are living in poor health for longer. Supporting inclusivity may be a way to close the gap and facilitate a healthy workforce.
We therefore argue that:
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There is more to health inclusion than funding
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Supporting health inclusivity will strengthen the workforce and the economy
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Countries should go beyond tracking crude outcomes data such as life expectancy and use measures that capture quality, such as healthy life expectancy.
This does not mean traditional healthcare systems are obsolete. Rather, we argue that universal health coverage is necessary–but not sufficient—for health inclusivity. Inclusive health requires that healthcare systems are accessible, easy to navigate, affordable and of decent quality. However, the most impactful part of the Index was found in “people and community empowerment”. This is where we measured how well countries provide individuals and communities with the tools to take charge of their own health— the best predictor of a country’s overall score.
Here are three ideas to empower people and communities:
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Have community health workers play a multidimensional role. Utilise them in both high- and low-income countries to better engage communities, debunk myths and dismantle cultural barriers to care
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Disseminate information for self-care in relevant languages to target populations to ensure that all dimensions of health–physical, mental, and emotional–are considered
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Support health literacy to increase health knowledge, build population level resilience, encourage positive lifestyle changes and empower people to effectively manage long-term health conditions.
To find out more,visit the Index Hub to read the white paper and explore the data.
