Equality and equity: necessary steps to build a healthier university
DOI:
https://doi.org/10.17533/udea.rfnsp.8749Keywords:
health promotion, equality, equity, healthy universityAbstract
The concept of health promotion emerged simultaneously with those of equality and equity. These concepts implied a change in the way in which the phenomena known as health and disease are explained, thus incorporating psychosocial and contextual perspectives. However, no critical reflection has been developed regarding how a healthy university should incorporate the perspectives of equality and equity in terms of health. Objectives: to describe the relationship between these concepts, identify the mechanisms that explain inequality, and propose steps to promote equity and equality at the university level. Methodology: a literature search using databases and reports recommended by experts (a total of 62 documents.). Results: we present definitions for the social determinants of health, equality, equity, and health promotion. We also review the evidence of social inequality and its impact on health in the university community. Likewise we discuss possible models explaining these inequalities and establish some possible steps to follow in order to reduce the differences in terms of health at the university level. Conclusions: a more equal and equitable university environment could contribute specifically to bring about a healthy life in its community. Achieving a university with a more egalitarian and equitable structure and culture is a challenging and complex task, but it will surely lead to success.
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(1). Muñoz M, Cabieses B. Universidades y promoción de la salud: ¿cómo alcanzar el punto de encuentro? Rev Panam Salud Pública 2008; 24(2): 139-46. DOI: https://doi.org/10.1590/S1020-49892008000800009
(2). Cabieses B, Muñoz M, Zuzulich MS, Contreras A. Como implementar la nueva ley chilena antitabaco al interior de la Universi-dad. Rev Panam Salud Pública 2008; 23(5): 361-368. DOI: https://doi.org/10.1590/S1020-49892008000500013
(3). Organización Panamericana de la Salud. Organización mundial de la salud. Consejo Directivo N°46, Sesión del Comité regional N°57. [internet] Washington: ops/oms; 2005 [acceso 18 de junio de 2008]. Disponible en: http://paho.org.
(4). Vio F, Lange I. Guía para universidades promotoras de la salud y otras instituciones de educación superior. Santiago: Ministerio de Salud; 2006.
(5). Organización Mundial de la salud. Sundsvall statement on supportive environments for health, 1991 [internet]. Geneva: oms; 1991. [acceso 13 de agosto de 2011]. Disponible en: http://who.org.
(6). Marmot M, Wilkinson R. Social Determinants of Health. Oxford: Oxford University Press; 1999.
(7). Organización Mundial de la salud. Ottawa Charter for health promotion [internet]. Geneva: oms; 1986 [acceso 05 de noviembre de 2009]. Disponible en: http://who.org.
(8). Organización Mundial de la Salud. The Yakarta declaration on health promotion for the 21st century [internet]. Geneva: oms; 1997 [acceso 02 de noviembre de 2009]. Disponible en: http://who.org.
(9). Carlisle S. Health promotion, advocacy and health inequalities: a conceptual framework. Health promotion int 2000; 15(4): 369-376. DOI: https://doi.org/10.1093/heapro/15.4.369
(10). Tarlov AR. Social Determinants of Health. En: Blane D, Brunner E, Wilkinson R, editores. Health and Social Organization. Lon-don: Routledge; 1999.
(11). Krieger N. A glossary for social epidemiology J. Epidemiology Community Health 2001; 55: 693-700. DOI: https://doi.org/10.1136/jech.55.10.693
(12). Graham H, Kelly MP. Health inequalities: concepts, frameworks and policy. NHS Briefing Paper [revista en internet] 2004 [acceso 12 de septiembre de 2009]. Disponible en: http://www.nhs.uk/Pages/HomePage.aspx
(13). Lomas J. Social capital and health: implications for public health and epidemiology. Soc Science and Med 1998; 47: 1181-1188. DOI: https://doi.org/10.1016/S0277-9536(98)00190-7
(14). Organización Mundial de la Salud. The Adelaide recommendations on healthy public policy [internet]. Geneva: oms; 1988 [ac-ceso 20 de octubre de 2010]. Disponible en: http://who.org.
(15). Kickbusch I, Draper R, O ́neill M. Healthy public policy: a strategy to implement the Health for all philosophy at various govern-mental levels. En: Evers A, Farrant W, Trojon A, editores. Healthy public policy at a local level. Vienna: European Centre for Social Welfare, Policy and Research; 1990.
(16). Organización Mundial de la Salud. csdh Towards a Conceptual Framework for Analysis and Action on the Social Determinants of Health. Discussion paper for the Commission on Social Determi-nants of Health [internet] 2008 [acceso 08 de septiembre de 2009]. Disponible en: http://www.who.int/social_determinants/en/.
(17). Irwin A, Valentine N, Brown C, Loewenson R, Solar O. The Commission on Social Determinants of Health: Tackling the Social Roots of Health Inequities. PLoS Med 2006; 3(6): e106. DOI: https://doi.org/10.1371/journal.pmed.0030106
(18). Organización Mundial de la Salud. Communities: Takling the root causes of ill-health. Commission on the social determinants of health [internet] 2005 [acceso 02 de junio de 2009]. Disponible en: http://www.who.int/social_determinants/en/.
(19). McGinnis JM, Williams-Russo P, Knickman JR. The Case for More Active Policy Attention to Health Promotion. Health Affairs 2002; 21(2): 78–93. DOI: https://doi.org/10.1377/hlthaff.21.2.78
(20). Krieger N. Theories for social epidemiology in the 21st century: an ecososial perspectiva. International Journal of Epidemiology 2001; 30: 668-677. DOI: https://doi.org/10.1093/ije/30.4.668
(21). Graham H. Social determinants and their unequal distribution: Clarifying policy understandings The Milbank Quarterly 2004; 82(1): 101-124. DOI: https://doi.org/10.1111/j.0887-378X.2004.00303.x
(22). Marmoreview.org UCL Institute of Healthy Equity [internet] [ac-ceso 13 de agosto de 2010]. Disponible en: http://www.instituteo-fhealthequity.org/.
(23). Liberatos P, Link B, Kelsey J. The measurement of social class in epidemiology. Epidemiologic reviews 1988; 10: 87-121. DOI: https://doi.org/10.1093/oxfordjournals.epirev.a036030
(24). Galobardes B, Shaw M, Lawlor DA, Lynch J, Davey Smith G. Indicators of socioeconomic position (part 1). J Epidemiol Com-munity Health 2006; 60: 7-12. DOI: https://doi.org/10.1136/jech.2004.023531
(25). Galobardes B, Shaw M, Lawlor DA, Lynch J, Davey Smith G. Indicators of socioeconomic position (part 2). J Epidemiol Com-munity Health 2006; 60: 95-101. DOI: https://doi.org/10.1136/jech.2004.028092
(26). Wilkinson RG, Pickett KE. The Spirit Level, Why More Equal Societies Almost Always Do Better. New York: Bloomsbury; 2009.
(27). Susser M, Susser E. Choosing a future for epidemiology: II. from black boxes to Chinese boxes and eco-epidemiology. Am J Public Health 1996; 86:674–677. DOI: https://doi.org/10.2105/AJPH.86.5.674
(28). Bottomore T. Interdisciplinaridad y ciencias humanas. España: Tecnos ediciones unesco; 1983.
(29). Hollingshead AB. Four factor index of social status. New Haven: Department of sociology. Yale University; 1975.
(30). Weber M. Class, status and party. En: Gerth H, Mills CW, edi-tores. From Marx Weber: essays in sociology. New York: Oxford University Press; 1946.
(31). Lipset SM. Social class. Int Encycloped Soc Sci 1968; 15: 298-316.
(32). Geyer S, Hemstrom O, Peter R, Vagero D. Education, income, and occupational class cannot be used interchangeably in social epidemiology. Empirical evidence against a common practice. J Epidemiol Community Health 2006; 60: 804–810. DOI: https://doi.org/10.1136/jech.2005.041319
(33). Lahelma E, Martikainen P, Laaksonen M, Aittomaki A. Pathways between socioeconomic determinants of health. J Epidemiol Community Health 2004; 58: 327–332. DOI: https://doi.org/10.1136/jech.2003.011148
(34). Rognerud MA. Zahl PH. Social inequalities in mortality: changes in the relative importante of income, education and household size over a 27-year period. Eur J Public Health 2006; 16: 62-68. DOI: https://doi.org/10.1093/eurpub/cki070
(35). Sellstrom E, Bremberg S. The significance of neighbourhood context to child and adolescent health and well-being: a systematic review of multilevel studies. Scand J Public Health 2006; 34: 544-554. DOI: https://doi.org/10.1080/14034940600551251
(36). Shohaimi S, Ningham S, Welch A, Luben R, Day N, Wareham N. Occupational social class, educational level and area depriva-tion independently predict plasma ascorbic acid concentration: a croos-sectional population study in the Nolfolk cohort of the European Prospective Investigation into cancer (EPIC-Norfolk). Eur J Clin Nutr 2004; 58: 1432-1435. DOI: https://doi.org/10.1038/sj.ejcn.1601979
(37). Bartley M. Health inequalities. An introduction to theories, con-cepts and methods. Polite Press: Cambridge; 2007.
(38). Marmot M. Introduction. In Social Determinants of Health, Ed. By Marmot M. & Wilkinson R.G. Chapter 1, pp 1-16. Oxford: Oxford University Press; 1999. DOI: https://doi.org/10.1093/acprof:oso/9780198565895.003.01
(39). Wilkinson RG. Unhealthy societies. The afflictions of inequality. London: Routledge; 1996.
(40). MacIntyre S, Hunt K. Socio-economic Position, Gender and Health: How Do They Interact? J Health Psychol 1997; 2: 315-334. DOI: https://doi.org/10.1177/135910539700200304
(41). Davey Smith G, Blane D, Bartley M. Explanations for socio-economic differentials in mortality: evidence from Britain and elsewhere. Eu J P Health 1994; 4, 131-134. DOI: https://doi.org/10.1093/eurpub/4.2.131
(42). Townsend P. Inequalities in health: The need to construct more comprehensive health policies. An HEA Occasional Paper. Health Education Authority, London, UK; 1998.
(43). Miller A, Archer J. Impact of workplace based assessment on doctors’ education and performance: a systematic review. BMJ 2010; 341: c5064. DOI: https://doi.org/10.1136/bmj.c5064
(44). El Ansari W, Stock C. Is the health and wellbeing of university students associated with their academic performance? Cross sec-tional findings from the United Kingdom. Int J Environ Res Public Health 2010; 7(2): 509-527. DOI: https://doi.org/10.3390/ijerph7020509
(45). Landstedt E, Gillander Gådin K. Deliberate self-harm and associated factors in 17-year-old Swedish students. Scand J Public Health 2010 Sep 16. [Epub ahead of print] DOI: https://doi.org/10.1177/1403494810382941
(46). Silverstein ST, Kritz-Silverstein D. A longitudinal study of stress in first-year dental students. J Dent Educ 2010; 74(8): 836-848. DOI: https://doi.org/10.1002/j.0022-0337.2010.74.8.tb04940.x
(47). Feliciano-Alfonso JE, Mendivil CO, Ariza ID, Pérez CE. Cardio-vascular risk factors and metabolic syndrome in a population of young students from the National University of Colombia. Rev Assoc Med Bras 2010; 56(3):293-298. DOI: https://doi.org/10.1590/S0104-42302010000300012
(48). Rasool S, Akram S, Mirza T, Mohammad ZA, Mohammad MA, Mirza A, Hussain I.Oral self screening among students of Dow University of Health Sciences. J Coll Physicians Surg Pak 2010; 20(6):357-360.
(49). Guo J, Whittemore R, He GP. Factors that influence health quotient in Chinese college undergraduates. J Clin Nurs 2010; 19(1-2):145-155. DOI: https://doi.org/10.1111/j.1365-2702.2009.03044.x
(50). Seubsman SA, Lim LL, Banwell C, Sripaiboonkit N, Kelly M, Bain C, Sleigh AC. Socioeconomic status, sex, and obesity in a large national cohort of 15-87-year-old open university students in Thailand. J Epidemiol. 2010; 20(1): 13-20. DOI: https://doi.org/10.2188/jea.JE20090014
(51). Nelson MC, Larson NI, Barr-Anderson D, Neumark-Sztainer D, Story M. Disparities in dietary intake, meal patterning, and home food environments among young adult nonstudents and 2- and 4-year college students. Am J Public Health 2009; 99(7): 1216-1219. DOI: https://doi.org/10.2105/AJPH.2008.147454
(52). Uddin M, Cherkowski GC, Liu G, Zhang J, Monto AS, Aiello AE. Demographic and socioeconomic determinants of influenza vac-cination disparities among university students. J Epidemiol Com-munity Health 2010; 64(9): 808-813. DOI: https://doi.org/10.1136/jech.2009.090852
(53). Thomas SP, Burk R. Junior nursing students’ experiences of vertical violence during clinical rotations. Nurs Outlook 2009; 57(4):226-31. DOI: https://doi.org/10.1016/j.outlook.2008.08.004
(54). McDonald PJ. Transitioning from clinical practice to nursing faculty: lessons learned. J Nurs Educ 2010; 49(3):126-131. DOI: https://doi.org/10.3928/01484834-20091022-02
(55). Zuzulich MS, Cabieses B, Pedrals N, Contreras L, Martínez D, Muñoz M, Espinoza MA Factores asociados al consumo de tabaco en el último año de vida por parte de estudiantes universitarios. Revista Investigación y Educación en Enfermería 2010; 28(2): 232-239.
(56). Lynch J, Davey Smith G, Harper S, Hillemeier M, Ross N, Kaplan GA et al. Is income inequality a determinant of population health? Part I. A systematic review. Milbank Q 2004; 82: 5-9. DOI: https://doi.org/10.1111/j.0887-378X.2004.00302.x
(57). Lynch SM. Explaining the lifecourse approach and cohort variation in the relationship between education and health: the role of income. J health Soc behave 2006; 47: 324-338. DOI: https://doi.org/10.1177/002214650604700402
(58). Wolfson M, Rowe G, Gentleman JF, Tomiak M. Career earnings and deaths: a longitudinal analysis of older Canadian men. J Ge-rontol 1993; 48,167-79. DOI: https://doi.org/10.1093/geronj/48.4.S167
(59). Davey Smith G. Health inequalities: lifecourse approaches. Bristol (UK): Policy Press; 2003. DOI: https://doi.org/10.56687/9781447342229
(60). Muñoz M, Cabieses B. Programa UC Saludable. [Presentación oral] III Congreso Internacional de Universidades Promotoras de Salud “Entornos formativos multiplicadores”. México: Universi-dad Autónoma de Ciudad Juárez; 2007.
(61). Lange I, Muñoz M. Construyendo una Universidad Saludable: la Experiencia de la Pontificia Universidad Católica de Chile. [Pre-sentación oral] Reunión de OPS y Universidad de Tucumán, Ar-gentina; 2009.
(62). Arroyo H, Price M, Franceschini MF, Valenzuela F, Equipo Latinoamericano de Universidades Promotoras de la Salud. Una nueva mirada al movimiento de universidades promotoras de la salud. [Documento de trabajo] IV Congreso Internacional de Uni-versidades Promotoras de la Salud. Pamplona, España del 7-9 de octubre; 2009.
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