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. 2024 Dec 4;2(1):81.
doi: 10.1186/s44263-024-00106-w.

Investigating inconsistencies regarding health equity in select World Health Organization texts: a critical discourse analysis of health promotion, social determinants of health, and urban health texts, 2008-2016

Michelle Amri  1 , Theresa Enright  2 , Patricia O'Campo  3   4 , Erica Di Ruggiero  3 , Arjumand Siddiqi  3   5   6 , Jesse B Bump  7   8
Affiliations

Investigating inconsistencies regarding health equity in select World Health Organization texts: a critical discourse analysis of health promotion, social determinants of health, and urban health texts, 2008-2016

Michelle Amri et al. BMC Glob Public Health. .

Abstract

Background: Scholarly critiques have demonstrated that the World Health Organization (WHO) approaches the concept of health equity inconsistently. For example, inconsistencies center around measuring health inequity across individuals versus groups; in approaches and goals sought in striving for health equity; and whether considerations around health equity prioritize socioeconomic status or also consider other social determinants of health. However, the significance of these contrasting approaches has yet to be assessed empirically.

Methods: This study employs critical discourse analysis to assess the WHO's approaches to health equity in select health promotion, social determinants of health, and urban health texts from 2008 to 2016.

Results: We find that the WHO: (i) usually measures health equity by comparing groups; (ii) explicitly specifies three approaches to health equity (although we identified additional implicit approaches in our analysis of WHO discourses); and (iii) considers health equity inconsistently both in terms of socioeconomic status and other social determinants of health, but socioeconomic status was given substantially more attention than other individual social determinants of health.

Conclusions: There is misalignment with the WHO's stated approaches to tackle health inequity and its discourses around health equity. This incongruence increases the likelihood of pursuing short-term solutions and not sustainably addressing the root causes of health inequity. Critical discourse analysis' focus on power allows for understanding why 'radical' approaches are not explicitly expressed to ensure that governments will be agreeable to addressing health inequity.

Keywords: Critical discourse analysis; Global health policy; Health equity; Health inequity; Health policy; Public health; Public policy; World Health Organization.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: MA reports short-term instances of consulting for the World Health Organization and membership with the World Health Organization Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity. ED reports co-directing the World Health Organization Collaborating Centre in Health Promotion. AS reports involvement on the World Health Organization Commission on Social Determinants of Health. The remaining authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Depiction of cross-referencing between selected texts The source of this figure is [29]
See this image and copyright information in PMC

References

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