Aiming for Health Equity: The role of Public Health Policy and Primary Healthcare Comment on "Universal Health Coverage for Non-Communicable Diseases and Health Equity: Lessons From Australian Primary Healthcare"

Bo Burström

doi:10.34172/ijhpm.2021.112

Abstract

This commentary refers to the article by Fisher et al on lessons from Australian primary healthcare (PHC), which highlights the role of PHC to reduce non-communicable diseases (NCDs) and promote health equity. This commentary discusses important elements and features when aiming for health equity, including going beyond the healthcare system and focusing on the social determinants of health in public health policies, in PHC and in the healthcare system as a whole, to reduce NCDs. A wider biopsychosocial view on health is needed, recognizing the importance of social determinants of health, and inequalities in health. Public funding and universal access to care are important prerequisites, but regulation is needed to ensure equitable access in practice. An example of a PHC reform in Sweden indicates that introducing market solutions in a publicly funded PHC system may not benefit those with greater needs and may reduce the impact of PHC on population health.

Highlights

Fisher et al[1] report on a policy analysis of primary healthcare (PHC) implementation in Australia from the perspective of universal health coverage (UHC), its strengths and weaknesses in addressing non-communicable diseases (NCDs), and how it contributes to equity in access to care and in health outcomes
The authors propose some recommended generic UHC features for PHC systems regarding ideas, actors and structures. They distinguish between PHC and primary medical care, and propose PHC, which has a wider scope, encompassing health promotion, disease prevention, community engagement and actions to address social determinants of health.[2]
Other features should be public health regulation to limit the impact of the food, alcohol and tobacco industry on NCDs, and regional PHC organisations for health planning and workforce planning, to ensure coordination between different levels of services and address social determinants of health

Summary

Introduction

Fisher et al[1] report on a policy analysis of primary healthcare (PHC) implementation in Australia from the perspective of universal health coverage (UHC), its strengths and weaknesses in addressing non-communicable diseases (NCDs), and how it contributes to equity in access to care and in health outcomes.

Results

Conclusion