Introduction
The domain of public health administration is critically mandated with addressing the deep-seated injustices in social, economic, and health spheres that damage the well-being of community health and cripple the ways of service delivery. They are evident in the uneven distribution of disease, life expectancy, and access to health care across the social pyramid (Ndugga & Artiga, 2023). This literature review engages a broad range of academic dialogue by analyzing current knowledge, the validity of research methods, and the gaps in existing literature. This analysis seeks to illuminate the complexity of health inequalities and create knowledge to support transformative policies and administrative actions in public health.
Methodology
The construction of this literature review followed a systematic approach as outlined in John’s Scholar, S., & Dimoff’s article. The object of study was limited to scholarly articles from the last decade to focus on the contemporary aspect. The search focused on peer-reviewed journals considered prestigious for their scholarly contributions to the field of public health. These include, but are not limited to, reputed journals like The American Journal of Public Health and Social Science & Medicine.
The keywords and phrases for the compiling literature were carefully selected to cover various topic dimensions. These included terms such as “health disparities,” “socioeconomic status,” and “public health administration,” among others (John’s Scholar & Dimoff). These keywords provided a thorough retrieval of studies that reflected social, economic, and health inequality aspects of public health administration.
The criteria for selection were strict in that they preferred studies that provided strong empirical evidence and critical reviews that provided enlightening analyses of already existing data (John’s Scholar & Dimoff). Moreover, I had to consider the credibility of the sources, and I focused on articles that passed stringent peer review processes. This approach guarantees that the literature review is anchored on significant scholarly works, which will serve as a solid background for analyzing the complications of inequality regarding public health administration.
Theoretical Framework
One analytical lens that can evaluate health inequalities is the fundamental cause theory, which argues that socioeconomic status constitutes an underlying determinant of health outcomes. Underlying most of the literature on public health disparities is the theory that disparities not only emanate from individual behavioral factors but lack equal access to essential resources such as nutritious food, safe living, environment and health, and services that create e-health. Riley (2020) points out that socioeconomic status is related to the development and sustenance of health disparities owing to its motives that act on the state of the person’s exploit to abstain from ventures and use protective stratagems when confronted with disease. For this reason, the theoretical model was paramount in driving the literature review since it provides an excellent structure for considering the engraved health inequality, ensuring that the reviewed literature was interpreted using a lens that considers the entrenched structural aspects inherent within the health outcomes.
Additional importance is given to the impossibility of considering socioeconomic status as the secondary factor contributing to health inequities. The theory elaborates more to note that the socioeconomic differences are not only related to health inequalities because the relationship is causal; the socially based resources linked to a higher socioeconomic status—may act as buffers against diverse health risks. Members of the higher class may exploit the existing resources to benefit health despite changes in diseases, risks, and societal basis, as discussed by Das et al. (2020). From this theoretical perspective, socioeconomic class as a predictor of health remains unchallenged in medical technology and health policy, even with improvements. This resilience suggests that the interventions to combat health inequities should tackle the fundamental socioeconomic determinants that cause different health system outcomes.
Review of Literature
Social Inequality:
Social injustice constitutes a fundamental issue determining health results in public health administration. From one study to another, it has been repeatedly established that individuals belonging to minorities have poor health outcomes generally, far more often than those belonging to the majority. This gap can be attributed to the dual combination of systematic acts and unfair provision of health facilities. Notably, the works of Keim-Klärner et al. (2023) illustrate the above process since they explain how overt and subtle discrimination affects health, e.g., by reducing economic security, adequate education, and culturally adapted medicine. In their view, discriminatory practices and policies negatively impact social determinants such as safe housing, nutrition, and preventive care, thus jeopardizing healthcare for certain minority groups.
The consequences of such findings are truly overwhelming; they demand policy actions meant to sabotage the firmly established paradigm of inequality. As Ferguson et al. state, policy should be the existence of policy other than just the delivery of health care but should encompass interventions that address the sources of discrimination. Taking a wider angle, public health administrators can bring in inclusive changes, increase healthcare accessibility, and make advancements in the social and economic factors contributing to health inequality. Policies might include laws that aim to reduce the pay gap, facilitate the same educational opportunities, and nurture anti-discrimination policies in medication. Such multidimensional interventions have to be put in place to minimize the effects of social injustice because they lead to fatal health outcomes and an unfair and unhealthy society.
Economic Inequality:
In public health, economic inequalities are a major barrier that affects low-income populations. The literature shows financial barriers are a major obstacle to accessing crucial healthcare services. This inequality is evident in the challenges that economically deprived persons have in getting prompt medical attention. For these reasons, such communities are frequently diagnosed late and subsequently treated, further worsening health disparities and propagating a poverty and disease cascade. In this respect, the study of Alamneh et al. (2022) is exceptionally informative; it describes the complicated connection between the financial person’s financial situation and health results. Their study shows that the lower the income, the higher the morbidity and mortality. The consequences of this relationship are far-reaching since it shows that economic position is not a mere backlog variable but a key determinant of health.
Economic barriers should be integrated into public health measures with economic policy. Macnaughton and Ahmed (2023) support interventions beyond symptoms of poverty; they suggest structural changes that help provide more healthcare for the economically disadvantaged. It can encompass the introduction of sliding-scale payment systems, greater allocation of funds to public clinics in impoverished areas, and economic reforms to reduce the divide between the rich and the poor. Their studies highlight the need for policy-level interventions that directly target the economic causes of health disparity. Public health administration can only deal with These fundamental economic disparities to realize equality of health outcomes across all socioeconomic strata.
Health Inequality:
Health inequalities appear in very significant ways regarding life expectancy and disease prevalence among different groups of people. This stratification of health outcomes can be directly seen in socially, racially, and even locally stratified communities. However, Ólafsdóttir goes further than the conventional assessment of genetics and personal health behaviors. Their findings highlight the significant role of external systemic factors in health. They contend that determinants such as access to health care, often influenced by policy and economic factors, contribute significantly towards widening or narrowing health disparities. The accessibility of healthcare provision, including preventive care and access to timely medical interventions, are listed among the critical factors determining the population’s health journey.
In addition, Ólafsdóttir moves on to the quality of healthcare services, which is no less important than the availability of services. Based on their results, even if health care is available, the quality of the care can differ significantly, resulting in differences in health conditions. This difference is not random but is associated with variables such as insurance coverage, preferences of care providers, and distribution of resources in health systems. The outcome of such variance is the perpetuation of health inequities, where the marginalized groups have lower quality care and, thus, poor health status. The study requires a comprehensive approach to health injustice, addressing the presence of healthcare services and their equitable distribution and quality to ensure everyone can be healthy.
Discussion
All these factors are interdependent and present a formidable challenge and a burden to public health administrators. Health inequalities are interlinked and design a complicated, intertwined network that multiplies the health gap in any population subset (Mills,2021). The view underlined in the literature is the importance of a holistic approach beyond medical treatment. Such entrenched inequalities should be abolished through far-reaching policy reforms that consider socioeconomic determinants of health. These policies have to drive straight to the source of poverty, education, or even medical facilities.
Moreover, the body of research points out that community participation is necessary to close the health gap. Public health initiatives must be appropriate for what they serve; thus, empowering communities to be involved in decision-making ensures that. Other changes in health care are needed as they should make this system more accessible and affordable and provide an excellent level of care for everyone. These multidimensional approaches form a comprehensive strategy for battling the complex health disparity problem, making society fairer and fairer.
Conclusion
The literature review highlights the complexity of public health administration’s social, economic, and healthcare disparities, showcasing a problem influenced by institutional factors. It is clear that to overcome these injustices, a strategic combination of policy innovation, community-based efforts, and systemic healthcare changes is necessary. Future research should focus on longitudinal research to assess the effectiveness and long-term consequences of such interventions. Such studies would yield important information on the temporal impacts of policy-level changes and targeted interventions, which would eventually inform better, more just public health frameworks and inform best practices that can reduce the persistent gap in health equity.
References
Mills, C. (2021, October 13). A review of evidence on socioeconomic disadvantage and inequalities of outcome (summary). GOV.WALES. https://www.gov.wales/review-evidence-socio-economic-disadvantage-and-inequalities-outcome-summary-html
Ólafsdóttir, S. (n.d.). Health Inequalities in the Nordic Countries: What We Know and What We Can Do. https://norden.diva-portal.org/smash/get/diva2:1569773/FULLTEXT01.pdf
Macnaughton, G., & Ahmed, A. K. (2023). Economic Inequality and the Right to Health: On Neoliberalism, Corporatization, and Coloniality. Health and Human Rights, 25(2), 105–110. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10733770/
Alamneh, T. S., Teshale, A. B., Yeshaw, Y., Alem, A. Z., Ayalew, H. G., Liyew, A. M., Tessema, Z. T., Tesema, G. A., & Worku, M. G. (2022). Socioeconomic inequality in barriers for accessing health care among married reproductive-aged women in sub-Saharan African countries: a decomposition analysis. BMC Women’s Health, 22(1). https://doi.org/10.1186/s12905-022-01716-y
Ferguson, L., Gruskin, S., Bolshakova, M., Rozelle, M., Yagyu, S., Kasoka, K., Oraro-Lawrence, T., Motala, A., Stackpool-Moore, L., & Hempel, S. (n.d.). Systematic review and quantitative and qualitative comparative analysis of interventions to address HIV-related stigma and discrimination. AIDS, 10.1097/QAD.0000000000003628. https://doi.org/10.1097/QAD.0000000000003628
Keim-Klärner, S., Adebahr, P., Brandt, S., Gamper, M., Klärner, A., Knabe, A., Kupfer, A., Müller, B., Reis, O., Nico Vonneilich, Ganser, M. A., Charlotte de Bruyn, & von. (2023). Social inequality, social networks, and health: a scoping review of research on health inequalities from a social network perspective. 22(1). https://doi.org/10.1186/s12939-023-01876-9
Riley, A. R. (2020). Advancing the study of health inequality: Fundamental causes as systems of exposure. SSM – Population Health, 10, 100555. https://doi.org/10.1016/j.ssmph.2020.100555
Das, K. V., Jones-Harrell, C., Fan, Y., Ramaswami, A., Orlove, B., & Botchwey, N. (2020). Understanding subjective well-being: perspectives from psychology and public health. Public Health Reviews, 41(1). https://doi.org/10.1186/s40985-020-00142-5
John’s Scholar, S., & Dimoff, L. (n.d.). EFFECTIVE ORGANIZATIONAL STRUCTURE AND LEADERSHIP EFFECTIVE ORGANIZATIONAL STRUCTURE AND LEADERSHIP THEORY FOR HOMELAND SECURITY ORGANIZATIONS THEORY FOR HOMELAND SECURITY ORGANIZATIONS. Retrieved February 5, 2024, from https://scholar.stjohns.edu/cgi/viewcontent.cgi?article=1485&context=theses_dissertations
Ndugga, N., & Artiga, S. (2023, April 21). Disparities in health and health care: 5 key questions and answers. Kaiser Family Foundation. https://www.kff.org/racial-equity-and-health-policy/issue-brief/disparities-in-health-and-health-care-5-key-question-and-answers/
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