Inequalities and health services

Resumo

The objectives of this paper are three: first to review the causes of inequalities in health and the role played by health services; second, to analyze the influence of health care financing and the organization of health services on inequalities in health and to show an example of the study of inequalities in health services utilization in Catalonia, an autonomous community of Spain where a National Health System exists. The following causes of health inequalities are analyzed: life styles or health behaviors, health services, material or structural factors, income inequalities and political factors. Health services are not the main determinants of health or of health inequalities. But the existence of health services is a fundamental need for everyone and the access to them should be a right for all people independently of their social characteristics. Quality and coverage of health services is an important part of development and they constitute main indicators of social wellbeing. Finally, it is shown an example of social class inequalities in health services utilization in Catalonia in 1994 and 2002, inequalities that are non existent for curative services but that still remain for preventive services.