Health inequalities : which role of the health system?

Lecture given online on 11 May 2021The workshop 'Turning the Tide: Contemporary Challenges to Health and Healthcare in Europe and Beyond' is organized as a series of 5 lectures with renowned speakers who have worked on the topic of health and healthcare from different angles, with the Max Weber Fellows acting as moderators in 2021.CHAIN is the leading centre and interdisciplinary research network for global health inequalities research. It brings together expert researchers in the field of health and their social determinants (from genes to society), WHO, the GBD Study, civil society and the UN system to advance health inequalities research, especially for children’s health. It seeks to monitor, explain and reduce inequalities. In this presentation, CHAIN leader Terje Andreas Eikemo will provide an example of its research through the role of health systems in understanding the social distribution of mortality. Many of the pathways connecting social position to health can potentially be found within healthcare systems. However, it is unclear whether some systems are associated with larger socioeconomic inequalities in mortality than others. This question is particularly relevant for fatal outcomes that would have been avoided with timely and effective health care. In order to advance research on macro-level explanations for cross-national differences in socioeconomic health inequality, we need to link country-level mechanisms to specific and system sensitive health outcomes rather than relying on general indicators of health or mortality. Supported by register data from several European populations, professor Eikemo will discuss the role that healthcare plays in the social distribution of mortality in Europe. More specifically, he asks to what extent the magnitude of educational differences in mortality amenable to healthcare vary among between European healthcare system types. He will also address possible mechanisms connecting healthcare systems, social position, and health. He will show that factors located within the healthcare system are relevant for health inequalities, as inequalities in mortality amenable to medical care are present in all healthcare systems, but also that important variations can be observed between the systems