Equity is the absence of avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically. Health inequities therefore involve more than inequality with respect to health determinants, access to the resources needed to improve and maintain health or health outcomes. They also entail a failure to avoid or overcome inequalities that infringe on fairness and human rights norms. Without addressing  the equity in health care Universal Health Coverage will not be achieved.

Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequities, and face worse health outcomes than those who are able to access certain resources. It is not equity to simply provide every individual with the same resources; that would be equality. In order to achieve health equity, resources must be allocated based on an individual need-based principle.

According to the World Health Organization, “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.The quality of health and how health is distributed among economic and social status in a society can provide insight into the level of development within that society. Health is a basic human right and human need, and all human rights are interconnected. Thus, health must be discussed along with all other basic human rights.

There are organisations must give regard to the need to reduce inequalities between patients in access to, and outcomes from healthcare services and to ensure services are provided in an integrated way where this might reduce health inequalities.

Many factors influence health including genetic factors, meaning that complete equality of health is never achievable. Equalizing health can be considered as paternalistic because it does not allow for individual preferences such as the choice to smoke. Aristotle’s formal theory of distributive justice makes the distinction between vertical and horizontal equity: horizontal equity refers to equity between people with the same health care needs, whilst vertical equity refers to those with unequal needs who should receive different or unequal health care.

1. i) Vertical equity – is the unequal treatment of unequals and can be justified on the basis of morally relevant factors, however, morally irrelevant factors should not be the basis for employing vertical equity:

*unless ability to benefit depends on these factors

1. ii) Horizontal equity– equal treatment of equals

That is to say, vertical equity can be justified in healthcare if morally relevant factors apply. However, morally irrelevant factors are not grounds for justifying vertical equity.

Policy makers of health care are constantly faced with decisions regarding equity, largely as a result of the need to prioritise and ultimately ration health care to conform to budgetary restraints. Common practice today is for policy makers to implement priority setting policies for the fair distribution of health care resources, largely based on the distinction between morally relevant and irrelevant factors. However, not all moral decisions will satisfy all and therefore any decision-making process regarding priority setting should be about achieving consensus and consistency rather than necessarily achieving the right answer.