LONDON, UK — According to a global study released by consumer health leader Haleon, people living in countries that successfully prioritize “health inclusivity,” whether policies, systems, or cultures that give everyone in society the chance to optimize their health, are more likely to live healthy lives for longer.
Devised by researchers at Economist Impact, the inaugural Health Inclusivity Index (HII) benchmarks 40 countries on the presence, coverage, and effectiveness of inclusive healthcare systems, processes and policies.
The Index finds that the United Kingdom has the most inclusive approach to healthcare at a national policy and program level, closely followed by Australia, France, Germany, and Sweden. Other countries in the top ten include South Korea, Canada, Israel, Thailand, and Switzerland.
The lowest-scoring countries for health inclusivity are India, Honduras, Egypt, Algeria, and Bangladesh. The Index demonstrates the levers governments, policymakers and others can use to address health inequity and promote inclusion, particularly for vulnerable and marginalized people and communities. As the Index measures health inclusivity inputs rather than disparities in outcomes, in some countries, people’s perceived experiences may reveal a gap between policy and practice.
According to the Index, countries’ wealth and health expenditure do not guarantee greater inclusivity in health. While universal health coverage is necessary, it is not sufficient to ensure inclusivity.
Countries with the highest overall scores equip individuals and communities with the tools they need to take control of their own health. Eight of the top 10 ranking countries achieved their highest scores for the metric of “People and Community Empowerment,” where the presence of initiatives like health literacy programs and community outreach enable people to proactively manage their own health.
Brian McNamara, chief executive officer, Haleon, said, “Everyone should have the opportunity to live in good health, but millions of people continue to face barriers. The inaugural Health Inclusivity Index highlights the barriers which lead to the vulnerable and marginalized being held back from and less included in opportunities for better everyday health.”
“Raising awareness and creating a global benchmark are vital first steps in addressing health inequity, but this is just the start. We are also collaborating with industry, government, academia, and other healthcare stakeholders to improve health inclusivity. This work is part of our commitment to empowering millions of people a year to be more included in opportunities for better everyday health, empowering 50 million a year by 2025.”
Nine of the 12 countries ranking highest for health inclusivity also score highest for healthy life expectancy. This suggests an inclusionary approach to healthcare may lead to people spending a greater proportion of their lives in good health.
For policymakers, this finding highlights the critical role health inclusivity has to play. Many countries are facing a spiraling challenge of health not keeping pace with increases in life expectancy. Consequently, people are living in poor health for a longer proportion of their lives, impacting personal well-being and piling more pressure on overburdened healthcare systems.
Half of all countries studied lacked a strategy, policy, or action plan to promote oral health. With a number of diseases and health conditions associated with poor oral health, the Index recommends that oral health assistance is actively included within universal health coverage systems, as seen in Brazil, for example.
David Napier, professor of medical anthropology at University College London and one of the principal advisors to the Economist Impact’s Global Health Inclusivity Index, said, ”The Index rightly recognizes the fact that health is largely made or lost outside the formal health sector. It brings together critically important data in domains whose importance has been largely undervalued because that data is hard to get. I believe that the indicators on People and Community Empowerment will emerge as the most important part of the Index. It is here that even cash-strapped countries can make progress, for empowering individuals and communities to manage their own health provides people with options that they may not otherwise have thought of or considered feasible.”
David Humphreys, global practice leader, health policy, economist impact, added, “We’re delighted to work with Haleon to launch the first of its kind Health Inclusivity Index. Motivated by the heightened attention from the pandemic around equity in health, the tool aims to support policymakers and advocates in identifying what levers countries can pull to both improve and make more equitable health outcomes.”
“The Index is ambitious in scope – linking concepts such as the social determinants of health, health in all policies, universal health coverage, cultural competency, personal agency, and community empowerment. We look forward to expanding the breadth and reach of the index over the coming years, and also leveraging the output to drive and measure meaningful change.”