In 2021 when we think of justice we may think of our court system, the disproportionately high incarceration rates of African Americans and Hispanics, inequalities of pay for women vs men, or a significant lack of funding for minority-owned small businesses amongst financial institutions and investment funds. One theme that may not be at the forefront of our word association is medical or healthcare justice, which refers to the opportunity for all to live a healthful life and access equitable and affordable quality care when it is needed.
In 2015 the United Nations launched the 2030 Agenda for Sustainable Development; a plan of action to address universal peace and prosperity for people and the planet by 2030. In it, the United Nations outlined 17 Sustainable Development Goals to address and measure progress on our world’s most pressing issues threatening a healthy and prosperous future. Goal 3, “ensure healthy lives and promote well-being for all at all ages” outlines 13 healthcare targets for equitable global health including reducing maternal mortality rates and ending the epidemics of AIDS, tuberculosis, malaria, etc. (UN SDG, 2015). For a large percentage of the population in the United States, healthcare is an assurance provided by parents, universities, employers or government programs.
However, a study conducted by the Commonwealth Fund in 2020 found that 43.4% of adults aged 19 – 64 were inadequately insured; 9.5% were insured but had a gap in coverage within the last year, 21.3% were fully insured, however out-of-pocket or deductible costs were so high relative to annual income they were considered underinsured, and 12.5% were completely uninsured. Inadequate healthcare coverage exposes individuals and families to high health care costs which often accumulate into medical debt. Among those who reported a medical bill or debt problem, 37% said they had used all of their savings to pay their bills, 40% received a lower credit rating as a result of their medical debt, 31% were forced to transfer medical debt to their credit cards, and one-quarter were unable to pay for basic necessities such as food, heat, or rent (Commonwealth Fund, 2020).
When we consider health and wellness on a global scale, we must consider all the variables that comprise good health including access to quality nutrition, clean water, sanitation facilities and supplies, basic medical services, and education for disease prevention and treatment. 36% of the world’s population, roughly 2.5 billion people, lack access to improved sanitation facilities, putting them at risk of several preventable diseases including dysentery, cholera, and typhoid (WHO, 2015). Furthermore, nutrition-related factors contribute to approximately 45% of deaths in children 5 years and under. Malnourished children have a higher risk of death from common childhood illnesses such as pneumonia and malaria. Children in sub-Saharan Africa are more than 15 times more likely to die before the age of five than children in high income countries. In addition, 94% of all maternal deaths occur in low and lower middle-income countries. In 2017 alone, 810 women died each day from preventable causes related to pregnancy and childbirth (UN SDG, 2021). Focusing on what is just in terms of access to basic needs but also access to a clean, safe environment and workplace improves overall wellness and with it productivity and prosperity while reducing the social and economic burdens that come with unwell communities.
Tune into our Wilde Capital Management ESG Week podcast 3: Medical Justice and Access to Healthcare where we discuss the structural challenges to achieving a global basic level of wellness, and how companies both in and out of the broad medical industrial complex can contribute to achieving greater global health with Ingrid Dyott, Managing Director and Portfolio Manager at Neuberger Berman.