The Relation Of Socioeconomic Status To Health Inequities And Inequalities

People from different backgrounds and social communities living in different countries enjoy health at different levels. In Australia, the level of health enjoyed by its citizens is generally good, however, good health is sometimes not shared equally. There are noticeable differences in the health status of different population group in Australia. For example, differences in life expectancy, mortality rates, incidences of diseases (especially NCDs) and usage of health services. This difference is attributable to ‘Health Inequity’ and ‘Health Inequality’.

Health inequity is the significant difference in the health status between various population groups due to external conditions outside the control of the population. In this case, the unequal distribution of resources or social circumstances maybe unfair or unjust. For example, differences in education, occupation, fresh food, income, employment status, rurality, ethnicity and gender. These unequal distribution cause inequities in health. In United States, infant mortality rates is 13 times higher in Hispanic blacks than Hispanic whites. The differences in infant death rates among this racial group is as a result of preventable difference in health education and access to prenatal care. Whereas, health inequality refer to measurable differences in health of individual or group of people and the observed differences are not subjected to fairness or just. The fact that young people enjoy better health than aged population is not unjust or unfair but health inequality because health differences based on age cannot be avoided or considered unjust since younger people would become old someday and older people were once young too.

Health inequities and inequalities within rural and remote populations, develop from greater exposure to social determinants of health leading to wide disparities in infectious, non-infectious and injury (intentional and unintentional) disease burdens. For example, Indonesia is home to diverse ethnic groups at the same time, absolute inequality persists across all regions of Indonesia; residents living in urban cities like Java and Bali enjoy higher life expectancy, low infant and maternal mortality rate. In 2010, maternal mortality rate in Java and Bali is reported to be 210 deaths per 100,000 live births, on the other hand, in Papua, eastern and remote part of Indonesia, the maternal mortality rate is 573 per 100,000 live births.

Various evidences point to the connection between characteristics of a place of residence and health outcomes even after accounting for individual risk factors. For the past two decades, about 30% of the Australian population lives in rural and remote areas, including areas outside major cities. In comparison with those who live in urban cities, residents in remote areas are exposed to more risk factors. Certainly, they are likely to be smokers, overweight or obese, have lower levels of education, work in risky environments, poorer access to medical services and generally have lower socioeconomic status. For instance, Australians living in rural and remote areas tend to experience poorer health outcomes; lower life expectancy, maternal and infant mortality and higher rates of diseases including Non Communicable Diseases.

In spite of the increased burden of illness in rural and remote areas, there is lack of access to health professionals and services. But, access to health care means little without access to adequate food and safe working conditions. In rural China, there is experience of the burden of malnutrition among children. The risk factors of child nutrition are complex and can differ according to different status of malnutrition. In the case of overweight or obesity among children living in China major cities, the improved economic status drives their preference for eating energy-dense foods, is determined by contextual actors such as physical inactivity environments and urbanisation. On the other hand, under-nutrition among children in rural China, for example underweight and stunting, are often as a result of inadequate food or nutrient deficiency in relation to deprived economic conditions.

The effect of the combination of different levels of remoteness and socioeconomic status (SES) on health and mortality are complex and it is yet to be understood till date. There is a strong association between socioeconomic status and health disparities. For example, preterm birth and intrauterine growth restriction have been consequently associated with people with lower socioeconomic status in Canada. With the infant mortality rates significantly higher in lowest income neighborhoods like British Columbia. Though, the cause of this disparity is not consistent, other factors like race, ethnicity degree of rurality, rates of smoking during pregnancy and other community‐level factors contribute to this health outcome.

Cardiovascular mortality and morbidity represent a high economic and health burden that disproportionately affect the indigenous population in Australia. For those living outside of major cities that is remote and rural areas, there is extremely higher levels of socioeconomic disadvantage compared to their metropolitan counterparts, an attribute also associated with increased preventable mortality and higher rates of chronic disease.

It is no doubt education, health, life expectancy, literacy, per capita income and human development in general have improved in all countries during the last decades. Beyond the global improvements, however, distribution of health inequities among the rural and remote residents relatively to their better off counterparts points to worse health outcomes for example, infant mortality rate. In rural provinces of China, about 20–50% of women of reproductive age have access to basic emergency obstetric care, likewise in India, the infant mortality rate is 50% higher in rural areas than in urban cities, with almost two-thirds of all households using private medical services due to poor quality or absent public services.

A recent review for North African countries, namely Algeria, Egypt, Libya, Morocco and Tunisia established that even though they belong in the same group called ‘Arab World’ as affluent countries, like Saudi Arabia and United Arab Emirates, the health indicators still show disparity with respect to health care access in the rural-urban or regional areas. As an example, more than 30% of the rural population in the remote north east of Morocco travel at least 10 kilometres to reach the nearest hospital because the ratio of available physician is 6362 to 380 in the capital, Rabat.

Health inequities within and between countries, population groups, gender, race are politically, socially and economically unacceptable, unfair and that the promotion of health equity is essential for a better quality of life and well-being for all, which in turn can contribute to peace and security. Health is determined by social and economic factors, thus, people living in rural and remote communities, indigenous people, people from different race and sometimes men and women are exposed to inequalities that stems from the inequities of health.


  1. Arcaya, M. C., Arcaya, A. L.and Subramanian, S. V. (2015). Inequalities in health. Global health action, 8, 27106. Retrived from http://doi.10.3402/gha.v8.27106
  2. Australia Institute of Health and Welfare (AIHW). (2014). Statistics on Australia’s health status and some data on health inequities.
  3. Australia Institute of Health and Welfare (AIHW). (2018). Statistics on Australia’s health status and some data on health inequities.
  4. Bailey, B. A. and Cole, L. K. (2009). Rurality and birth outcomes: findings from southern Appalachia and the potential role of pregnancy smoking. Journal of Rural Health, 25(2), 141–149. Retrieved from
  5. Baum, F. (2015). The New Public Health. ProQuest E-book Central. Retrieved from
  6. Borrell, C., Pons-Vigués, M., Morrison, J. and Díez, È. (2013). Factors and processes influencing health inequalities in urban areas. Journal of Epidemiology Community Health, 67, 389–391. Retrieved from
  7. Boutayeb A: Social inequalities and health inequity in Morocco. International Journal for Equity in Health. 2006, 5: 1-10.1186/1475-9276-5-1. Retrieved from
  8. Boutayeb, A. and Helmert, U. (2011). Social inequalities, regional disparities and health inequity in North African countries. International Journal for Equity in Health, 10(23), 1-9. Retrieved from
  9. Brennan‐Olsen, S. L., Williams, L. J. and Holloway, K. L. (2015). Small area-level socioeconomic status and all-cause mortality within 10 years in a population‐based cohort of women. Preventive Medicine Report, 2: 505– 11. Retrieved from
  10. Bureau of Statistics Indonesia. (2012). Indonesia Demographic and Health Survey.
  11. Centers for Disease Control and Prevention (CDC). (2011). Health disparities and inequalities report. Morbidity and Mortality Weekly Report, 60:49–51. Retrieved from
  12. Chand, M (2012). Health equity in Australia with a focus on culturally diverse populations. Retrieved from
  13. Dang, S., Yan, H. and Wang, D. (2014). Implication of World Health Organization Growth Standards on estimation of malnutrition in young Chinese children: Two examples from rural western China and the Tibet region. Journal of Child Health Care, 18: 358–368. Retrieved from
  14. Grundy, J. (2014). Improving average health and persisting health inequities - Towards a justice and fairness platform for health policy making in Asia. Journal of Health policy and Planning, 29(7), 873-882. Retrieved from
  15. He, W., James, S. A., Merli, M. G. and Zheng, H. (2014). An increasing socioeconomic gap in childhood overweight and obesity in China. American Journal of Public Health, 104: e14–e22.
  16. Hodge, A., Firth, S., Marthias, T. and Jimenez-Soto, E. (2014). Location matters: trends in inequalities in child mortality in Indonesia. PLoS One, 9(7):e103597.Retrieved from http//doi.10.1371/journal.pone.010359
  17. Houweling, T. A. J. and Kunst, A. E. (2010). Socio-economic inequities in childhood mortality in low- and middle-income countries. Medical Bulletin, 93:7-26. Retrieved from http://doi-10.1093/bmb/ldp048
  18. Kawachi, I., Subramanian, S. V. and Almeida-Filho, N. (2002). A glossary for health inequalities. Journal of Epidemiology Community Health, 56(9):647-52. Retrieved from http://doi.10.1136/jech.56.9.647
  19. Kissoon, K., Larson, C. and Kissoon, N. (2012). Health inequities: causes and potential solutions. Australia and New Zealand Journal of Public Health, 36:518-519. Retrievd from http://doi.10.1111/j.1753-6405.2012.00952.x
  20. Monda, K. L., Gordon-Larsen, P., Stevens, J. and Popkin, B. M. (2007). China's transition: the effect of rapid urbanization on adult occupational physical activity. Journal of Social science & medicine, 64: 858–870. Retrieved from
  21. National Rural Health Alliance (NHRA). (2015). The Little Book of Rural Health Numbers. Retrieved from
  22. Nichols, M., Peterson, K., Alston, L. and Allender, S. (2011). Australian Heart Disease Statistics. National Heart Foundation of Australia.
  23. Suryadarma, D., Widyanti, W., Suryahadi, A. and Sumarto, S. (2006). From Access to Income: Regional and Ethnic Inequality in Indonesia. Retrieved from
  24. World Health Organisation (WHO). (2008). Building the knowledge base on the social determinants of health: Review of seven countries in the Eastern Mediterranean Region. Retrieved from
  25. World Health Organisation. (2012). Health Impact Assessment Glossary of Terms. Retrieved from
  26. Zhang, N., Bécares, L. and Chandola, T. (2016). Patterns and Determinants of Double-Burden of Malnutrition among Rural Children. PLOS ONE, 11(7): e0158119. Retrieved from
09 March 2021
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