Social Inclusion and the Role of the Health Care System (original) (raw)

1 Introduction The continual contesting of definitions and terminology for social inclusion/exclusion is at risk of creating “white noise” allowing governments to minimize their responsibility and role in proactive responses that decrease discrimination and increase social and cultural engagement. The roles and responsibilities of government are central to the extent to which the health system provides social inclusion. It has been known for several decades of the “foundational” causes of ill-health and disease which are rooted in the broader concepts of health, including methods of interventions and delivery (Hankivsky and Christoffersen 2008). Therefore, waiting for illness or disease to “present” misses the strategic and fundamental opportunities to promote health, well-being, and health equity (Hankivsky and Christoffersen 2008). All health systems deal with diversity, for example, gender, race, class, and sexual orientation (Hankivsky and Christoffersen 2008); the extent to which the diversity is acknowledged, embraced, and incorporated into service delivery informs social inclusion practices and ideologies. For example, many health service providers are female and yet wage disparity between female and male providers for those services continue to exist (Treadwell 2019; Lagasse 2020; Mainardi et al. 2019). Treadwell (2019) states that the health system itself results in poor health and poverty among female health care workers. Female staff with the same qualifications, hours, and role expectations on average receive >10% less than their male counterparts (Treadwell 2019; Lagasse 2020; Mainardi et al. 2019). This inherent and foundational inequity perpetuates a social structural system that at its core is unequitable and discriminatory. Therefore, addressing social structures and systemic barriers that perpetuate current power relationships requires determined political will. This could undo the structures that reinforce social exclusion.

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