Policies to reduce inequality in the capability to be alive and to live a healthy life

Government policy plays a key role in shaping inequalities in this domain, as policy can ameliorate as well as exacerbate inequalities in health and mortality. These include policies to address unequal access to quality and timely healthcare, clean water, sanitation and a healthy diet. As inequalities in mortality are affected by differences in the protection of individuals from natural disasters and non-natural causes, candidate policies include investment policy and regulation designed to reduce risks overall and unequal exposure to these risks.

Through your application of the MIF you will have identified the main inequalities within this domain and you should use this information along with your analysis of drivers within main driver category to inform your work on identifying the most effective policies to reduce these inequalities.

Explore the candidate policies by main driver categories in Domain 1.

Policies by main driver categories

To find a selection of candidate policies, click on the main driver categories below.

1.1 Lack of adequate resources for, and unequal access to, quality and timely healthcare

• Policies that deliver universal, free at the point of use high-quality healthcare. Funding healthcare via tax, removing all user fees and adequate investment in infrastructure and affordable provision and care; would include preventative, primary, emergency and trauma, curative and palliative healthcare.
• Policies related to the provision of universal, high quality maternal and child healthcare: antenatal, delivery and post-natal services, services to protect women’s sexual and reproductive health, and services to protect children’s health such as immunisation, growth monitoring, disease prevention and treatment efforts.
• Policies to ensure children with disabilities receive early assessments to identify developmental delays and put in place appropriate healthcare plans.
• Policies related to the provision of primary, specialist and continuing healthcare services, especially for people with complex or additional physical or mental health care needs; provisions to ensure accessibility of community and hospital health services for people with learning disabilities, to ensure health promotion and prevention activities equally target people with disabilities and to ensure overall accessibility and affordability of adequate services for people with disabilities.
• Policies that address mental health problems with adequate systems, services and resources including: the implementation of mental health information systems, quality improvement strategies, strategies to integrate mental health into general healthcare, deinstitutionalise mental health care and develop community mental health services, as well as improving access to psychotropic drugs and psychological therapies (cognitive behavioural therapies), providing targeted support in relevant institutions (e.g. prisons, detention centres) and promoting efforts to combat stigma against those who suffer from mental illness.
• Policies that ensure the provision of substance abuse services, coordinated with mental health services and integrated into the healthcare system and widely available throughout the country; prevention programmes at the school, family and community level to prevent substance abuse; provisions to tackle prescription drug abuse including education about the dangers of prescription drugs.
• Policies that remove or discourage the provision of private health insurance as a recognised employment benefit in countries with universal, free access to healthcare and policies that require that the provision of private health insurance is fully (and possibly disproportionately) taxed as a monetary benefit within employment contracts.
• Tax policies that apply differentiated rates to private healthcare providers (e.g. higher corporate tax rates, lower deductibles) with the stated aim to recover the cost to the public system of educating healthcare workers who then work within the private sector (with funds being ring-fenced for public health).

1.2 Unequal access to clean water, adequate sanitation and good nutrition

• Policies related to public health and prevention measures; public education on nutrition with the goal of promoting healthier diets; investment in healthy living programmes including opportunities for children and adults to exercise; and other policies to combat the obesity epidemic.
• Policies related to increasing service coverage of clean water supply and sanitation systems, promoting better hygiene practices, improving water quality and guaranteeing affordability of water and sanitation services for people living in poverty, especially in rural areas.

1.3 Unequal exposure to accidents, disasters and environmental risks

• Policies related to disaster risk reduction, including specific investments (e.g. flood defences, disaster-resistant dwellings) in disaster-prone zones and other policies to ex-ante reduce risk such as policies governing planning consent on high risk land and building regulations regarding architectural features, structural engineering and relevant defences.
• Policies related to climate change adaptation, investment in emergency planning and in early warning and weather data systems.
• Policies to reduce risk of death and serious injury in road traffic accidents (e.g. speed limits and traffic calming zones, construction of pavements and safe crossing zones, speed cameras to monitor speed and system of fines and penalties, automatic speed fixing controls fitted on certain vehicles, obligatory use of seatbelts and standards for vehicle maintenance).
• Policies designed to reduce the risk of death and serious injury in the workplace, including a robust regulatory and inspection regime.

1.4 Harmful social and cultural norms which result in certain groups being at greater risk of premature death or poor health

• Policies to protect women at risk of violence and domestic homicide such as the provision of safe accommodation, as well as policies to ensure that violence against women is reported / recorded, prosecuted within criminal justice system and that women are afforded dignity and respect during their treatment by police and the criminal justice system.
• National action plans to combat racial and religious discrimination, including equipping specialized bodies to analyse legislation, monitor compliance and undertake activities to promote racial equality.
• Policies that seek to break the cycle of gang membership and violence in deprived neighbourhoods (especially the culture of carrying knives, guns or other offensive weapons), including supporting the work of NGOs and local community groups.

1.5 Legal impunity, state violence and institutional discrimination

• Policies related to standards of policing including training in relation to human rights obligation, as well as systems to safeguard against cruel and unusual treatment and punishment, police brutality, and rules related to the composition of the police force (i.e. having women and minorities across all levels).
• Policies related to the treatment and safety of prisoners in detention (i.e. regulating violence in prisons, ensuring access to adequate physical and mental healthcare and prevention of self-harm and suicide).

1.6 Inadequate and unequal distribution of security and protection infrastructure and resources, and effective regulation of dangerous and offensive weapons

• Policies related to adequate policing in terms of coverage of police, presence of officers in (particularly exposed) neighbourhoods and improving the ability of police to control violence and protect lives; includes strategies such as partnerships among law enforcement, schools, communities, youth organisations to respond to chronic gang problems and improve effectiveness of law enforcement in affected neighbourhoods.
• Policies related to gun control that seek to regulate, restrict and decrease gun ownership and sales (exclusions for certain people, detailed background checks and registration requirements, mandatory waiting periods, mandatory safety training courses, buy-back programmes and gun amnesties), as well as provisions to ban certain types of firearms (e.g. concealed, semi-automatic or military style weapons) and to strictly regulate sellers and dealers involved in distribution, promotion and sales.
• Policies related to the appropriate control of offensive weapons, for example restricting the sale, carrying and use of knives or other articles made for (or adapted for) causing injury, as well as provisions to ban certain types of offensive weapons (flick knives, daggers, swords etc.) and substances (eg acid), and knife amnesties.

1.7 Lack of regulation of health practitioners and companies whose activities compromise public health

• Policies that regulate corporate practice in relation to health. These could include price controls and more ‘public interest’ patent policies to ensure affordability of drugs and medical equipment. Such as, policies that prohibit, limit or otherwise control corporate advertising of products harmful to health (tobacco, alcohol, processed foods and beverages implicated in the obesity crisis). In addition, policies that determine and enforce public health standards in relation to product development, content and manufacturing (e.g. food and beverage ingredients) are included here.
• Regulatory policies related to medical practitioners including those practicing alternative therapies.

1.8 Unequal knowledge regarding health and health care options

• Policies that promote public health education and knowledge. Support for groups who provide help and guidance for those without lacking adequate knowledge of healthcare and treatment options.
• Appropriate training among healthcare professionals to reduce health outcome inequalities due to differences in patients' knowledge of their healthcare and treatment options.