The global financial crisis and health equity: toward a conceptual framework

Abstract

In this article, we identify pathways that link the global financial crisis to health equity. We distinguish between direct and indirect channels of influence, and develop a conceptual model that builds on the literature analyzing the impacts of globalization on social determinants of health. The most pertinent direct pathways discussed are economic contraction, health budget cutbacks, rise in unemployment, and qualitative transformations of health systems. We also outline how other indirect channels of influence are likely to affect health equity, including cutbacks to welfare programs, labor market transformations, the emergence of an ideological climate conducive to austerity politics, and reductions in official development assistance. We conclude by suggesting that the current intensification of neoliberal policy implementation is likely to undermine health equity, and that a different path toward economic recovery is required to ensure equitable access to health care.

Keywords:

• health equity
• global financial crisis
• population health
• social determinants of health
• health governance

Acknowledgments

Arne Ruckert was supported in this study through the Emerging Researcher Award by the Population Health Improvement Research Network (PHIRN), funded through the Ministry of Health and Long-Term Care, Province of Ontario. Ronald Labonté is supported through the Canada Research Chair Program of the Government of Canada.

Notes

Note

1. Policy space can be defined as the freedom, scope, and mechanisms governments have to choose, design, and implement public policies to fulfill their aims (Koivusalo et al. 2008).