Abstract
It’s summertime, and the livin’ ain’t easy. It’s particularly hard for people who are on low incomes. It’s hard for people seeking elective care and appointments in primary care. It’s hard for young people starting out on their working lives. It’s hard for people of all income brackets feeling the pinch of a rise in cost of living and interest rates. If living was ever meant to be easy, two papers highlight the persistent impact of inequalities on everything from long COVID to artificial intelligence.1,2
Leaders and gurus promise a better world, one of health and prosperity, yet they rarely promise one of equity. The reason perhaps is that for those in power, equity is a path to erosion of that power – and only a rare person gives up power readily. The people who understandably make the strongest stand and demand for equity and fairness are the people who are disadvantaged and marginalised.
The roll call of people demanding equity and fairness is growing – and it would be wrong to suggest otherwise. Equity and fairness have their advocates in every sphere. Take medical research, for example, many of the developments in trial and study design, including “double blind” methodology, 3 are to eliminate bias and ensure fairness in the evaluation of interventions. Good people still argue for equity and fairness from a position of power and privilege, virtues that should be integral to the practice of the healing arts.
Yet the reality is that however many people are arguing for a more equitable world, it isn’t enough. Inequalities are widening in the UK and around the world. The impact on the health and wellbeing of people of the poorest and least advantaged backgrounds is disproportionately affected. These aren’t opinions, these are facts, and they should matter to health professionals everywhere.
If our primary objective is to improve the health and wellbeing of the populations that we serve, then arguing for a more equitable world should be central to our work – a position that becomes complicated when we realise that the drivers of inequalities are largely outside the health sector and stray into territories that are overtly political.
The question then is what comes first your political allegiance or your sworn duty as a health professional. My answer is to choose health and wellbeing, and that choice should not be precluded by political allegiance. When we choose health and wellbeing, we also choose equity – and the hope that, one day, livin’ is easy.