If you have easy access to health information, education, technologies, medicine and care to prevent illness, as well as to treatment when you do get sick, you are health rich. If all of those are out of your reach, you are health poor. And if you are health poor, your chances of surviving childhood are challenged in ways the health rich would find difficult to imagine.
The enormity of difference between the health rich and the health poor is detailed by World Vision in the report The Killer Gap: A Global Index of Health Inequality For Children, and it is a difference, according to the report, that is the basis of why, for all of the scientific and technological progress of recent decades, 19,500 children younger than five years old die every day. It is a gap that exists not only between, but within wealthy countries and poor ones. It is measurable, and it can be filled. Among the factors widening the gap between those who have and don’t have access to health are discrimination, socio-eonconomic patterns, and policies directing how health money is spent. World Vision’s Global Health Gap Index is based on four indicators that result from those factors: Life expectancy, personal cost of using health services, adolescent fertility rate, and number of doctors, nurses and midwives for every 10,000 people in a country.
While the largest gaps persist in the poorest countries, wealthy countries have wide chasms between the health rich and health poor as well. While seven of the 10 countries with the largest gaps between health rich and health poor are among the world’s poorest countries, the report notes, that group also includes Equatorial Guinea, considered a high income country. Of the 176 countries ranked according to health equity, the United States, at No. 46, squeaks into the top 50. Cuba, an economically challenged and resource poor island nation is in the top 10.
Prioritizing attention to health access for women and children, filling in data on uncounted populations, working within communities to plan and evaluate health services are among the measures to close the gap.
The report includes case studies illustrating deficits that widen the gap: lack of birth registration, conflict-caused displacement, child labor and trafficking, children left orphaned, and unmet family planning and maternal care needs.