The Asia Pacific region is home to more than 60% of the world’s population. Life expectancy at birth differs between countries by as much as 27 years. This article suggests that asymmetric economic growth, unplanned urbanization, marked environmental change, unequal improvements in daily living conditions, and the unequal distribution and access to quality health care have contributed to health inequities in the Asia Pacific region. Contextually specific evidence and action are needed. This requires ongoing monitoring of health inequities and systematic evaluation of societal changes and their impact on health inequities. It requires better understanding of how to translate theoretical and empirical demonstrations of the social and environmental impact on health inequities into evidence-informed policies and programs, in diverse geopolitical, socioeconomic, and sociocultural contexts across the Asia Pacific region and the range of associated complex policy processes. A spotlight is needed on health inequities and their causes else the status quo will persist.
Commission on Social Determinants of Health.Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health. Final report of the Commission on Social Determinants of Health. Geneva , Switzerland: World Health Organization; 2008.
2.
Friel S., Marmot M., McMichael A., Kjellstrom T., Vågerö D.Global health equity and climate stabilization- need for a common agenda. Lancet. 2008;372:1677-1683.
3.
United Nations Economic and Social Commission for Asia and the Pacific.Economic and Social Survey of Asia and the Pacific 2010. Sustaining Recovery and Dynamism for Inclusive Development. New York, NY: United Nations; 2010.
4.
Walker R., Pellissery S.Giants old and new: promoting social security and economic growth in the Asia and Pacific Region. Paper presented at: The International Sociological Association Annual Academic Conference "Social Policy in a Globalizing World: Developing a North-South Dialogue" ; September 6-8, 2007 ; Florence, Italy.
5.
United Nations Economic and Social Commission for Asia and the Pacific.Emerging Issues of Health and Mortality in the Asian and Pacific Region. New York, NY: United Nations; 2005.
6.
Economic and Social Commission for Asia and the Pacific.Statistical Yearbook for Asia and the Pacific 2009. Bangkok , Thailand: United Nations Economic and Social Commission for Asia and the Pacific; 2010.
7.
Black RE, Cousens S., Johnson HL, et al; Child Health Epidemiology Reference Group of WHO and UNICEF.Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010;375:1969-1987.
8.
Papua New Guinea National Statistical Office.2008Demographic and Health Survey. Preliminary Results. Port Moresby, Papua New Guinea: National Statistical Office; 2009.
9.
World Health Organization.The Global Burden of Disease: 2004 Update. Geneva, Switzerland: World Health Organization; 2009.
10.
Rajaratnam J., Marcus J., Levin-Rector A., et al. Worldwide mortality in men and women aged 15-59 years from 1970 to 2010: a systematic analysis . Lancet. 2010;375:1704-1720.
11.
Ministry of Planning and Investment.Millennium Development Goals 2010 National Report: The Vietnam 2/3 of the Way Achieving the Millennium Development Goals and Towards 2015. Hanoi, Vietnam: Ministry of Planning and Investment ; 2010.
12.
Gwatkin D., Rutstein S., Johnson K., Suliman E., Wagstaff A., Amouzou A.Socio-Economic Differences in Health, Nutrition, and Population Within Developing Countries-An Overview. New York, NY: World Bank; 2007.
13.
Fujino Y., Tamakoshi A., Iso H., et al; JACC study group.A nationwide cohort study of educational background and major causes of death among the elderly population in Japan. Prev Med. 2005 ;40: 444-451.
14.
Kagamimori S., Nasermoaddeli A., Sun Y., Sekine M.Study of a mortality surge among transport workers in Japan. J Occup Health. 2006;48:514-516.
15.
Kondo N., Kawachi I., Hirai H., et al. Relative deprivation and incident functional disability among older Japanese women and men: prospective cohort study. J Epidemiol Community Health. 2009;63:461-469.
16.
Byung Chul A., Engelhardt K., Joung H.Income-related health inequalities in Korea . Asia Pac J Public Health. 2010;22:32-41.
17.
Anderson I. , Crengle S., Kamaka M., Chen T., Palafox N., Jackson-Pulver L.Indigenous health in Australia, New Zealand, and the Pacific. Lancet . 2006;367:1775-1785.
18.
World Health Organization.Women and Health: Today’s Evidence Tomorrow’s Agenda. Geneva, Switzerland: World Health Organization;2009.
19.
Sen A.Development as Freedom. New York, NY: Alfred A. Knopf; 1999.
20.
Preston S.The changing relation between mortality and level of economic development . Int J Epidemiol. 2007;36:484-490.
Social Exclusion Knowledge Network.Understanding and Tackling Social Exclusion. Final Report of the Social Exclusion Knowledge Network of the Commission on Social Determinants of Health. Geneva, Switzerland: World Health Organization; 2007.
23.
Labonte R., Schrecker T., Packer C., Runnels V.Globalization and Health: Pathways, Evidence and Policy. New York, NY: Routledge; 2009.
24.
Blouin C., Chopra M., van der Hoeven R.Trade and social determinants of health. Lancet. 2009;373: 502-507.
25.
Brooks DH, Hua C.Asian trade and global linkages. Asian Dev Rev. 2009;26(1):103-128.
26.
Hill H., Jongwanich J.Outward foreign direct investment and the financial crisis in developing East Asia. Asian Dev Rev.2009;26(2):1-25.
27.
Fa’alili-Fidow J.Ensuring economic, health, and social well-being for Papua New Guinea through trade. Asia Pac J Public Health . 2011;23:79-85.
28.
Thow AM, Swinburn B., Colagiuri S., et al. Trade and food policy: case studies from three Pacific Island countries. Food Policy. 2010;35:556-564.
29.
Asian Development Bank.Key Indicators for Asia and the Pacific 2009. Mandaluyong, Philippines: Asian Development Bank; 2009.
30.
Alkire S., Santos M.Acute Multidimensional Poverty: A New Index for Developing Countries . Working paper no. 38. Oxford, UK: Oxford Poverty & Human Development Initiative ; 2010 .
31.
Wilkinson R., Pickett K.The Spirit Level: Why Equality Is Better for Everyone. London, UK: Penguin Books;2010.
32.
Bartley M.Job insecurity and its effect on health. J Epidemiol Community Health. 2005;59:718-719.
33.
Benach J., Muntaner C.Precarious employment and health: developing a research agenda. J Epidemiol Community Health. 2007;61:276-277.
34.
Tsui A.Asian wellness in decline: a cost of rising prosperity. Int J Workplace Health Manage. 2008;1:123-135.
35.
International Labour Organization.Global Employment Trends. Geneva, Switzerland: International Labour Organization; 2010.
36.
Unesco.Regional Adult Illiteracy Rate and Population by Gender 1970-2015. Montreal , Canada: Institute for Statistics UNESCO; 2002 .
37.
Son M.Why the educational effect is so strong in differentials of mortality in Korea ? Int J Epidemiol. 2004;33:308-310.
38.
Gupta R.Smoking, educational status and health inequity in India. Indian J Med Res. 2006;124:15-22.
39.
United Nations Economic and Social Commission for Asia and the Pacific.Looking Into Pandora’s Box: The Social Implications of International Migration in Asia. New York, NY: United Nations Economic and Social Commission for Asia and the Pacific; 2008. http://www.unescap.org/esid/psis/population/popseries/APSS_164/APPSSS_164.pdf . Accessed February 9, 2011.
40.
Oecd.International Migration Outlook 2008. Paris, France: OECD ; 2008.
41.
Irudaya-Rajan S.Population Ageing and Health in India. Mumbai, India: The Centre for Enquiry into Health and Allied Themes; 2006.
42.
World Health Organization.1000 cities 1000 lives. http://1000cities.who.int/ .
43.
Un-Habitat.State of the World Cities. Harmonious Cities2008/ 2009. Nairobi, Kenya: United Nations Human Settlements Programme; 2008.
44.
Bloom D., Canning D.The health and wealth of nations. Science. 2000;287:1207-1209.
45.
World Health Organization.Cities and Public Health Crises: Report of the International Consultation 29-30 October 2008 Lyon, France. Geneva, Switzerland: World Health Organization; 2009.
46.
Allender S. , Lacey B., Webster P., et al. Level of urbanization and noncommunicable disease risk factors in Tamil Nadu, India. Bull World Health Organ. 2010;88:297-304.
47.
Friel S., Baker PIEquity, food security and health equity in the Asia Pacific region . Asia Pac J Clin Nutr. 2009;18:620-632.
48.
Ameratunga S., Hijar M., Norton R.Road-traffic injuries: confronting disparities to address a global-health problem. Lancet. 2006;367:1533-1540.
49.
United Nations Economic and Social Commission for Asia and the Pacific.Emerging Issues of Health and Mortality in the Asian and Pacific Region. Asian Population Studies Series No.163. New York, NY: United Nations; 2005.
50.
Grnuhe.Improving Urban Health Equity Through Action on the Social and Environmental Determinants of Health: Final Report of The Rockefeller Foundation Global Research Network on Urban Health Equity. London, UK: University College London and the Rockefeller Foundation; 2010.
51.
Roberts B., Kanaley T.Urbanization and Sustainability in Asia. Case Studies of Good Practice. Manila, Philippines: Asian Development Bank; 2006.
52.
Ministry of Health and Family Welfare.Meeting the Health Challenges of the Urban Population Especially the Urban Poor. New Delhi, India: Ministry of Health and Family Welfare ; 2008.
53.
Naiker U.Managing the Transition From the Village to the City in the South Pacific . New York, NY: Macroeconomic Policy and Development Division, UNESCAP; 2003.
54.
Patz J., Gibbs H., Foley J., Rogers J., Smith K.Climate change and global health: quantifying a growing ethical crisis . EcoHealth. 2007;4:397-405.
55.
Intergovernmental Panel on Climate Change.Climate Change 2007: The Physical Science Basis. Contribution of Working Group I to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. New York, NY: Cambridge University Press; 2007.
56.
United Nations Development Programme.Human Development Report: Fighting Climate Change: Human Solidarity in a Divided World. New York, NY: United Nations Development Programme; 2007.
57.
Australian Greenhouse Office.Have Methane Levels Stabilised?Australian Greenhouse Office, Department of the Environment and Heritage. http://www.climatechange.gov.au/science/hottopics/. Accessed July 21, 2008.
58.
Research Australia.Health Planet, Places and People. Sydney, Australia: Research Australia; 2007.
59.
Burke EJ, Brown SJ, Christidis N.Modeling the recent evolution of global drought and projections for the twenty-first century with the Hadley Centre Climate Model. J Hydrometeorol . 2006;7:1113-1125.
60.
Yusuf A., Francisco H.Climate Change Vulnerability Mapping for Southeast Asia. Singapore: Economy and Environment Program for Southeast Asia; 2009.
61.
International Fund for Agricultural Development.Climate Change Impacts in the Asia Pacific Region. Rome, Italy: International Fund for Agricultural Development ; 2009.
62.
World Bank.World Development Report 2010: Development and Climate Change. Washington, DC: World Bank; 2010.
63.
Patz J., Campbell-Lendrum D., Holloway T., Foley J.Impact of regional climate change on human health. Nature . 2005;438:310-317.
64.
Victora CG, Fenn B., Bryce J., Kirkwood BRCo-coverage of preventive interventions and implications for child-survival strategies: evidence from national surveys. Lancet. 2005;366:1460-1466.
65.
Papua New Guinea Department of Health.National Health Plan 2011-2020: Strengthening Primary Health Care for All & Improving Service Delivery to the Rural Majority & Urban Disadvantaged . Port Moresby, Papua New Guinea: Department of Health Papua New Guinea; 2010 .
66.
O’Donnell O., van Doorslaer E., Rannan-Eliya RP, et al. Who pays for health care in Asia?J Health Econ. 2008 ;27:460-475.
67.
World Health Organization.Global Health Observatory 2009. Geneva, Switzerland: World Health Organization; 2010.
68.
Ministry of Health and Health Partner Group.Joint Annual Review 2008: Health Financing in Viet Nam . Hanoi, Vietnam: Vietnam Ministry of Health and Health Partner Group; 2008.
69.
van Doorslaer E., O’Donnell O., Rannan-Eliya R., et al. Effect of payments for health care on poverty estimates in 11 countries in Asia: an analysis of household survey data. Lancet. 2006;368:1357-1364.
70.
Lönnroth K., Aung T., Maung W., Kluge H., Uplekar M.Social franchising of TB care through private GPs in Myanmar: an assessment of treatment results, access, equity and financial protection. Health Policy Plan . 2007;22:156-166.
71.
Lieu D., Long N., Bales S.Study of Treatment Expenditure for Some Diseases at Provincial General Hospitals . Hanoi, Vietnam: Medical Publishing House; 2005.
