The concept of ‘‘equity’’ in health-promotion articles by Nordic authors - A matter of some confusion and misconception

Aims: This paper focuses on equity in health, one of the key principles of the Ottawa Charter. It aims at analysing and discussing how the concept was defined, applied, and integrated in health-promotion articles by authors with a Nordic affiliation. Methods: Abstracts were first identified by the search word ‘‘health promotion’’ as a key word. The search was limited to 1986—2008 and abstracts written in English by authors with a Nordic affiliation. Abstracts/articles for the present study were subsequently selected from these abstracts using the search word ‘‘equity’’ and analysed by quantitative and qualitative content analysis. Findings: A majority of the 18 articles in the study did not include any proper definition of the term ‘‘equity in health’’. Most articles dealt with health in general or ‘‘Health for All’’ aspects and did not focus on specific strategies for vulnerable individuals or groups. The theoretical papers had a clear focus on equity aspects even though the concept of equity was sometimes included in an implicit way. In contrast, most papers reporting empirical studies did not specifically target equity aspects. Instead, the analysis gave the impression that many authors used the term ‘‘equity’’ synonymously with ‘‘equality in health’’. Conclusions: The findings may indicate that the concept of ‘‘equity in health’’ has been attenuated or even forgotten by Nordic health-promotion researchers and needs to be re-established as a strong concern within health promotion.