Whitehead M
The Old School, Ash Magna, Whitchurch, Shropshire, England.
Int J Health Serv. 1992;22(3):429-45. doi: 10.2190/986L-LHQ6-2VTE-YRRN.
In 1984, the 32 member states of the World Health Organization European Region took a remarkable step forward in agreeing unanimously on 38 targets for a common health policy for the Region. Not only was equity the subject of the first of these targets, but it was also seen as a fundamental theme running right through the policy as a whole. However, equity can mean different things to different people. This article looks at the concepts and principles of equity as understood in the context of the World Health Organization's Health for All policy. After considering the possible causes of the differences in health observed in populations--some of them inevitable and some unnecessary and unfair--the author discusses equity in relation to health care, concentrating on issues of access to care, utilization, and quality. Lastly, seven principles for action are outlined, stemming from these concepts, to be borne in mind when designing or implementing policies, so that greater equity in health and health care can be promoted.
1984年，世界卫生组织欧洲区域的32个成员国向前迈出了非凡的一步，一致商定了该区域共同卫生政策的38项目标。公平不仅是这些目标中的首要目标，而且被视为贯穿整个政策的一个基本主题。然而，公平对不同的人可能意味着不同的事情。本文探讨了在世界卫生组织“人人享有健康”政策背景下所理解的公平概念和原则。在考虑了人群中观察到的健康差异的可能原因——其中一些是不可避免的，一些是不必要的和不公平的——之后，作者讨论了与医疗保健相关的公平问题，重点关注获得医疗服务、利用医疗服务和医疗质量等问题。最后，概述了从这些概念中衍生出来的七项行动原则，在设计或实施政策时应牢记这些原则，以便促进健康和医疗保健方面更大的公平性。
