Latest news with #healthinequality
Mail & Guardian
6 days ago
- Business
- Mail & Guardian
Sanitation crisis in Ramaphosa informal settlement dehumanises people
There is a sanitation crisis In numerous informal settlements around South Africa. Photo: Sewage waste. Delwyn Verasamy/M&G There is a sanitation crisis in the Ramaphosa informal settlement in Emfuleni, Vereeniging, Gauteng. On 20 May, Eyewitness News reported that residents were forced to use buckets and pit latrines to relieve themselves because the mobile toilets had not been cleaned for several months. Frieda Veeris, who lives in Ramaphosa, expressed her dissatisfaction with the situation and told of the unbearable stench and the maggots in the toilet bowls. She was concerned that her family would be vulnerable to infections from the toilets. The sanitation crisis is not only an inhumane injustice to the people living in this informal settlement but also an environmental issue that is overlooked and often ignored by the government. The inequality experienced by the residents of Ramaphosa has affected their health, because the failure to clean the mobile toilets has resulted in constant illnesses. The suspension of environmental services means people living in informal settlements such as Ramaphosa are prone to premature death and reproductive issues, especially women and girls, because they contract infections. The degrading living conditions in Ramaphosa informal settlement dehumanise people. This is the dismantling of a black community, a violence with compounding issues. The ablution facilities have not been serviced because the Emfuleni local government says it does not have the money to pay for it. It has prioritised the economy over human lives. While residents continue to battle the sanitation crisis, the Emfuleni municipality has responded with a request for residents to give them five more months to clean the toilets. How are people expected to survive in these five months? Although the national government has set clear targets for housing, implementation at the municipal level is an issue, with reports of corruption and mismanagement hindering progress. But corruption should not be an excuse for lack of accountability and action. This further increases the gap between the elites and the poor, where the poor always get the short end of the stick, almost reproducing the injustices of apartheid. It could be argued that informal settlements are spreading rapidly because people are occupying land and erecting shacks without going through the appropriate channels. OFM news reporter Kekeletso Mosebetsi reported that President Cyril Ramaphosa expressed concern regarding the prevalence of informal settlements during a door-to-door campaign trail in Botshabelo, Bloemfontein. The RDP programme has a huge backlog with more than 2.4 million households still in need of their promised house. Experts have further warned that the housing issue could continue to rise to a predicted 71% by the year 2030. The National Development Plan, which was introduced in 2012 as a vision for 2030, is said to aim to unite South Africa, unleash the energies of its citizens, build an inclusive economy, enhance the state and leaders working together to solve complex problems. This is in the very first line of the NDP page online. South Africa is plagued by unemployment, electricity issues, a healthcare system that is slowly deteriorating and informal settlements that are predominantly populated by black people who continue to live in unbearable conditions with their rights constantly being violated. With only five years left until 2030, perhaps it is time we face the reality that the vision is all that it is — a vision. The government should look back at the National Development Plan and the 31 years of democracy and see what it has achieved. Kabelo Motswagae holds an MA in sociology from the University of Johannesburg and Nokuthula Pheza is a PhD candidate in the Department of Sociology, University of Johannesburg.
BreakingNews.ie
27-05-2025
- Health
- BreakingNews.ie
Health inequalities worsening despite improvements in economic measures, report finds
A new report by the Economic and Social Research Institute (ESRI) has revealed 'clear evidence' of a widening health gap between the most and least disadvantaged communities. The ESRI study, commissioned by Pobal, examines socioeconomic conditions across communities in Ireland. Advertisement Using Census data, the study examines how potential barriers to social inclusion have changed over time and if disadvantaged communities are particularly adversely affected. The report highlights both progress and challenges in Ireland's efforts to promote social inclusion, showing a mixed picture of improving economic conditions alongside worsening health inequalities. Findings from the new research report, published on Tuesday, were collated using the Pobal HP Deprivation Index and two waves of Census data from 2016 and 2022. It found that between 2016 and 2022, some of the potential barriers examined have decreased, while others became more prevalent in certain communities. Advertisement Rates of unemployment and low educational attainment have declined, with the most significant falls occurring in more deprived areas, narrowing the disadvantage gap between affluent and deprived areas. However, the study found a rise in poor health, with increases most pronounced in the most deprived areas, which has exacerbated pre-existing health inequalities. It said that such trends are likely influenced by the Covid-19 pandemic and reflect worsening health outcomes for people living in disadvantaged communities. The report stated that it raises 'important considerations' for healthcare resourcing and allocation across the country in the coming years. Advertisement It also found that some factors are more common in urban or rural areas, further reinforcing the value of examining these barriers spatially. Decline in unemployment was found to be most pronounced in 'independent urban towns', meaning towns which tend to be further from cities and more likely to lack economic opportunities. It also found that the prevalence of ethnic minority populations at the area-level increased across most area types, with largest increases in the more urban areas. According to Pobal, a social inclusion agency working on behalf of Government, barriers to social inclusion are multifaceted and can overlap. Advertisement The ESRI examined at an area-level a range of factors that can act as potential barriers to social inclusion, including unemployment, economic inactivity, low educational attainment, lone parenthood, being a carer, ethnic minority status, having a disability and poor health. It found that while the presence of these characteristics do not always limit individuals' participation in society, they can be associated with a greater risk of social exclusion or marginalisation, particularly when co-occurring. Author of the report, Dr Anne Devlin, said: 'The findings of this report highlight differences in how potential barriers to social inclusion have changed between 2016 and 2022 and how they manifest spatially across Ireland. 'Our findings around a reduced prevalence of economic barriers, such as unemployment, are welcome. Advertisement 'However, questions remain about the quality of the employment. Despite these economic improvements, their resilience in the face of current and future challenges is uncertain.' Ireland Migrants more likely to be in work than Irish-born... Read More Anna Shakespeare, chief executive of Pobal, who commissioned this research, said: 'Understanding the prevalence and patterns of potential barriers to social inclusion is crucial for enabling evidence-based policymaking. 'The publication of this research is particularly timely in the context of the update to Ireland's national public health strategy, 'Healthy Ireland', as well as the re-development of the cross-Government Roadmap to Social Inclusion. 'As an agency working to promote social inclusion and community development, we are committed to bringing forward robust and reliable research which can support Government policy development at this critical juncture.'
Medscape
21-05-2025
- Health
- Medscape
Is Universal Healthcare a Realistic Ask for Europeans?
Out-of-pocket costs are silent barriers to healthcare, said João Vasco Santos, MD, PhD, president of the Public Health Economics Section at the European Public Health Association. 'They result in financial hardship and unmet health needs in every European country, disproportionately affecting various groups, particularly those experiencing social vulnerability. These costs delay treatment, exacerbating health inequality even further. They are also the most regressive form of health financing,' he told Medscape Medical News . João Vasco Santos, MD, PhD In 2023, nearly 4% of adults in the European Union (EU) reported having unmet medical needs, and close to 5% experienced unmet dental needs. Although the EU generally offers extensive healthcare coverage, significant barriers persist for certain vulnerable groups, including the need to pay out of pocket for services such as optical treatments, dental care, physiotherapy, reproductive health, psychotherapy, and prescribed medicines for common chronic conditions. According to the World Health Organization (WHO), up to 1 in 5 European households face catastrophic health costs, leaving them unable to afford essentials like food, housing, and heating. Another 1%-12% of households end up in poverty or even worse financial struggles due to out-of-pocket healthcare payments. Experts told Medscape Medical News that, to improve healthcare access, especially to vulnerable groups, EU countries need to learn from each other's experiences, set benchmarks, and collect high-quality data. The Cost of European Healthcare 'We see out-of-pocket payments in every health system in Europe,' said Sarah Thomson, PhD, senior health financing specialist at the WHO Barcelona Office for Health Systems Financing. These payments result when people are not entitled to publicly financed healthcare but also when co-payments are required for covered healthcare, particularly for outpatient prescribed medicines, she explained. Sarah Thomson, PhD 'Even among high-income individuals, there are times when they may face financial hardship due to out-of-pocket spending, particularly regarding certain medical products or dental care,' said Santos. Thomson explained that healthcare accessibility and costs vary significantly across the EU. For example, in the Netherlands, prepaid public funding covers approximately 80%-90% of healthcare costs, leaving only about 10% to be paid out of pocket. In contrast, Italy has significantly higher out-of-pocket expenses, accounting for around 23% of its current health spending. 'The more countries invest publicly in their health systems, the less people usually have to pay out of pocket,' said Thomson. 'As a result, the share of total health spending from out-of-pocket payments is much smaller in the Netherlands than in Italy.' This isn't the only factor that affects access to healthcare, however. Another factor is whether the healthcare system is designed to include co-payments and whether low-income households are exempted or if there is an income-based cap on them, Thomson explained. Understanding Two Different Approaches European healthcare financing varies widely from being primarily through the government budget, like in Italy, to heavily relying on employer and employee social insurance contributions, like in the Netherlands, or something in between, such as in France. Thomson said that users can face some level of co-payment in any of these models. In 2023, out-of-pocket payments represented 23% of Italy's €176 billion healthcare bill, up by 10% from the previous year, explained Domenica Matranga, PhD, professor of medical statistics at the University of Palermo, Palermo, Italy, to Medscape Medical News . 'There was a dramatic increase because this is the effect of the enormous public debt we have and of unacceptably long waiting lists.' Italy's National Health Service is funded through general taxation and provides universal coverage for all citizens and residents, with hospitals and most primary care services largely free at the point of use. While each region is responsible for organizing and delivering health services, the essential benefits package is established nationally and must be offered uniformly throughout the country. Still, there are problems. There is a significant disparity in access to high-quality healthcare between the north and south. Additionally, Italians are required to make co-payments for certain services, including medicines, outpatient specialist visits, diagnostic tests, and dental care. And even though financial support is provided for very young children, pensioners, and the unemployed, for example, there is no overall cap on co-payments. The Netherlands, on the other end, operates under a social health insurance system. Dutch residents must register for mandatory healthcare insurance, and they all receive at least a government-defined basic benefits package. They pay monthly insurance premiums and have an annual deductible of approximately €385. They do not need to make additional payments for general practitioner visits or standard hospital care. However, they must pay the initial portion of their healthcare costs related to non–primary care services out of pocket each year before their insurance coverage takes effect. 'We have universal health coverage that is quite comprehensive in the Netherlands,' said Pieter Bakx, PhD, an associate professor affiliated with the Health Economics group at the Erasmus School of Health Policy and Management, Rotterdam, the Netherlands. 'The defined set of benefits is relatively broad, and co-payments tend to be low. This applies particularly to long-term care; when compared to neighboring countries, people pay relatively low user fees.' Pieter Bakx, PhD The Dutch population typically reports low levels of unmet medical treatment needs. They do have some out-of-pocket expenses for services such as adult dental work, physiotherapy beyond a certain limit, and eyeglasses. However, their out-of-pocket spending is far below the EU average. To cover expenses that fall outside the basic benefits package of their insurance, they usually purchase supplementary voluntary health insurance policies. Toward Fairer European Healthcare 'Introducing an EU-wide benchmark or target for all countries would be a good approach to improving healthcare affordability in our continent,' said Santos. A good equity-based benchmark could be for no more than 2% of EU households to experience catastrophic health spending, he said. 'Then, consider coverage, coverage, coverage. I think it's all about coverage policies and trying to showcase how these coverage policies in some countries are achieving results in terms of access to healthcare.' Thomson added that learning from one another is often overlooked. Despite the potential benefits of observing how other countries address common problems, she said there is typically a surprising lack of understanding about these approaches. This gap exists partly because policymakers often lack the time to explore international solutions when faced with immediate crises, and because politics is a cyclical process and people constantly change. There is significant need to actively promote and support the sharing of experiences and knowledge among different countries, she said, but quality data are necessary before information can be shared. 'I think the EU can play a significant role in data collection, ensuring that countries gather information on who experiences unmet healthcare needs, who face financial hardship, and the reasons behind this,' Thomson added. 'The EU could do more to encourage member states to collect this data more regularly because data is very powerful.' Bakx emphasized that Europeans are all in the same boat. The population is aging, which means that the demand for healthcare will increase while the supply of healthcare workers will decrease. 'The big challenge now, and even more in the future, is the demographic transition,' agreed Franca Maino, PhD, associate professor of social and political sciences at the University of Milan, Milan, Italy, and scientific director of the Percorsi di Secondo Welfare Observatory. 'So it's really crucial to have a guiding framework at the EU level to develop long-term care systems in all member states. As of now, some countries don't have a [proper] long-term care system.' Franca Maino, PhD
BBC News
15-05-2025
- Health
- BBC News
Life expectancy gap growing in York, council health report says
People living in the most affluent parts of York live an average of 11 years longer than those in the poorest, according to a council in the Westfield ward can expect to live to around 80 on average and men to about 76, it said, compared to roughly 92 and 87 respectively in of York Council's report said trends were heading in the "wrong direction", with a rise in poverty, unemployment, overcrowded homes, obesity and substance misuse in more deprived comes as the council's Health and Wellbeing Board heard updates on work to try and reduce inequalities between the richest and poorest areas in the city by 2032. Peter Roderick, council public health director, said the number of years people were spending living in ill health across York had recently increased. The report states men in York could expect to live in ill health for an additional 2.4 years compared to figures a decade ago, with an additional 3.6 years for women. Roderick said efforts to try and reverse health trends included brain health cafés, welfare advice and supervised teeth brushing in the board meeting heard government plans to cut disability benefits could make problems worse, the Local Democracy Reporting Service Williams, a disability rights campaigner, told the meeting: "It's strikingly clear that the government's proposed cuts to social security are taking us in the wrong direction."How are council services preparing for the tsunami of need coming your way?"Ministers said the measures aim to stop a spiralling welfare bill and the reforms will introduce greater protections for those unable to work while supporting those who councillor Lucy Steels-Walshaw, the council's health spokesperson, said they were committed to supporting those in need including those affected by the government's proposals. Listen to highlights from North Yorkshire on BBC Sounds, catch up with the latest episode of Look North.
The Guardian
12-05-2025
- Health
- The Guardian
Asthma figures show ‘shocking' health inequalities in England, charity says
People from minority ethnic backgrounds in the most deprived areas of England are up to three times more likely to need emergency treatment for asthma than their white counterparts, analysis has found. Analysis of NHS statistics conducted by the charity Asthma and Lung UK found that Asian people with asthma from the most deprived quintile in England are almost three times more likely to have an emergency admission to hospital than their white counterparts. Black people with asthma in the most deprived quintile are more than twice as likely than their white counterparts to be admitted to hospital. People with chronic obstructive pulmonary disease (COPD) aged between 45 and 54 in the most deprived quintile are nine times more likely to be admitted as an emergency than those in the least deprived quintile, according to the analysis. Across the UK, one in five people will develop a lung condition during their lifetime, while asthma affects one in nine adults and one in eight children. Asthma and Lung UK conducted a survey of more than 9,000 people living with a lung condition across England this year, which found that more than a third (34.2%) of respondents who had experienced material deprivation had used emergency care in the past year. Almost a fifth (17%) of respondents said they struggled to keep their home warm, rising to almost a third (28.2%) of renters. Sarah Sleet, the charity's chief executive, said the figures highlighted 'shocking health inequalities in our society'. Sleet said: 'The UK has the worst death rate in Europe for lung conditions and they are more closely linked to inequality than any other major health condition. The fact that people from the most deprived communities and from ethnic minority backgrounds are much more likely to reach crisis point is yet another wake-up call. 'Social disadvantages – including poor housing, mould, damp and air pollution – can both cause chronic lung conditions and make them worse. And it's the poorest in society and those in ethnic minority communities who are more likely to be living in low-quality housing and in areas with high levels of air pollution.' She said the government's 10-year plan for the NHS was an 'unmissable opportunity' to ensure respiratory health was prioritised. 'People with lung conditions need quick, accurate diagnoses and access to treatment and services enabling them to manage their condition well, improve their quality of life and remain part of the workforce for longer,' she said. 'This means action to cut smoking rates and support smokers to quit, tackle air pollution and address wider issues such as poor housing.' Dr Hugo Farne, a respiratory consultant at Imperial College with a specialist interest in asthma, said the statistics revealed a 'deeply troubling reality'. 'These figures are not just statistics – they reflect lives being cut short or limited by health inequalities that should not exist in modern Britain,' Farne said. 'There will be many reasons for this, including higher rates of smoking, increased exposure to air pollution, poor indoor air quality due to damp, health literacy, and variable access to GPs, stop-smoking services and vaccination, particularly where there are language and cultural barriers. These are largely preventable. 'These figures are a clear sign that healthcare support is not reaching those who need it most. This requires urgent action, not only on healthcare access and provision for disadvantaged communities but also targeted public health interventions addressing housing, heating and the social determinants of health.' NHS England has been approached for comment.
