National Association of County & City Health Officials [Printer-friendly version] March 16, 2005 RESOLUTION TO PROMOTE HEALTH EQUITY Resolution 05-02 WHEREAS, according to the Ottawa charter of the World Health Organization, "The fundamental conditions and resources for health are peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice and equity. Improvement in health requires a secure foundation in these basic prerequisites." and WHEREAS, multiple UN Human Rights documents and charters establish the linkage between equity, social justice, human rights, and health and specifically Article 25 of the Universal Declaration of Human Rights, adopted by the United Nations General Assembly in 1948, states "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his/her family, including food, clothing, housing, and medical care;" and WHEREAS, with regard to almost every disease and chronic illness, socioeconomic disadvantage causes or contributes to early death and preventable disease and principal causes of socioeconomic disadvantage are classism, racism, and sexism; and WHEREAS, social justice is a core value of public health, and the birth of public health was rooted in the principles of social justice; and WHEREAS, inequities in the fundamental resources and conditions needed for health are avoidable; and WHEREAS, health inequities harm the entire society, wasting human potential and financial resources; and WHEREAS, the disadvantages producing inequitable outcomes in health status are interconnected, cumulative, intergenerational; THEREFORE, BE IT RESOLVED THAT the National Association of County and City Health Officials (NACCHO) supports the incorporation and adoption of principles of equity, social justice, and human rights into social policy, public health curricula, workforce development initiatives, and in the design of program evaluation measures, as strategies to maximize health outcomes and minimize health inequities; and BE IT FURTHER RESOLVED that NACCHO supports the transformation of public health practice to include: a) training in the principles and practice of equity, social justice, and human rights, b) inclusion of the principles of equity, social justice, and human rights in public policy and c) the development and regular application of social indicators that measure the nation's social health and well being, including inequities in health status, on a regular basis, similar to the way the nation uses economic indicators; and BE IT FURTHER RESOLVED that NACCHO will collaborate with partner organizations, government agencies, and community groups in the promotion of equity, social justice and human rights as a critical strategy to improve health outcomes and decrease health inequities worldwide. Proposed by Health and Social Justice Committee Adopted by NACCHO Board of Directors March 16, 2005 Notes  World Health Organization, Ottawa Charter for Health Promotion, 1986.  Note, this was also echoed in the constitution of the World Health Organization and was ratified by subsequent international covenants and conventions. For a detailed discussion of health and human rights, see Sofia Gruskin and Daniel Tarantola, "Health and Human Rights," in R. Detels, J. McEwen and R. Beaglehole, H. Tanaka, eds. Oxford Textbook on Public Health. Oxford, England: Oxford University Press, 2002: Chapter 4. See also United Nations, Office of the High Commissioner for Human Rights, International Covenant on Economic, Social and Cultural Rights, Geneva: Switzerland, 1976.  Douglas Black, Margaret Whitehead, et al. Inequalities in Health, Harmondsworth: Penguin, 1992; Donald Acheson, Independent Inquiry into Inequalities in Health. London: The Stationery Office, 1998. Available from the Publications Centre, PO Box 276, London SW8 5DT; Kawachi, Ichiro, Bruce P. Kennedy, and Richard G. Wilkinson. The Society and Population Health Reader: Income Inequality and Health. New York: The New Press, 1999; James W. Lynch and George A. Kaplan, "Understanding How Inequality in the Distribution of Income Affects Health" 2 Journal of Health Psychology (1997): 297-314; Kawachi, Ichiro. "Income Inequality and Health," in Social Epidemiology, Lisa Berkman and Ichiro Kawachi, eds. New York: Oxford University Press, 2000; R. G. Wilkinson, Unhealthy Societies. New York,: Routledge, 1996; Mary Shaw, Danny Dorling and George Davey Smith, "Poverty, Social Exclusion and Minorities," in Social Determinants of Health, Michael Marmot and Richard Wilkinson (eds.) New York: Oxford University Press, 1999; Ichiro Kawachi and Bruce Kennedy; Dennis Raphael, "The Question of Evidence in Health Promotion" 15 Health Promotion International (2000): 355-67. It should be noted that the documentation of the relationship between health inequalities and income inequality was developed in the 1970s. See for example, A. Wagstaff and E. Van Doorslaer, "Income Inequality and Health: What Does the Literature Tell Us? 21 Annual review of Public Health (2000): 543- 67.J.W. Lynch with George Kaplan, E.R. Pamuk, et al. "Income Inequality and Mortality in Metropolitan Areas of the United States." American Journal of Public Health 1998; 88:1074-1080; David R. Williams with C. Collins. "U.S. Socioeconomic and Racial Differences in Health: Patterns and Explanations." Annual Review of Sociology. 1995; 21:349-386; Commonwealth Fund. U.S. Minority Health: A Chartbook. New York, May, 1999; R.G. Evans, M.L. Barer, and T.R. Marmot, eds. Why Are Some People Healthy and Others Are Not? Determinants of Health of Populations. New York: Aldine de Gruyer, 1994.  See Christopher Hamlin, Public Health and Social Justice in the Age of Chadwick: Britain 1800-1854. London: Cambridge University Press, 1998; Nancy Krieger, "A Vision of Social Justice as the Foundation of Public Health: Commemorating 150 Years of the Spirit of 1848," 88 (11) American Journal of Public Health (November, 1998): 1603-1606.  See George Davey Smith, C. Hart, D.Blane, C. Gillis, and V. Hawthorne. "Lifetime Socioeconomic Position and Mortality: Prospective Observational Study" 314 British Medical Journal (1997): 547-52; D. Kuh and Y. Ben-Shilmo, A Lifecourse Approach to Chronic Disease Epidemiology. Oxford: Oxford University Press, 1997.