Consider the following statements and images. What role, if any, do power and privilege play in these situations? Is privilege created or reinforced? Is there an effort to offset power imbalances?
1. Governments in Canada have invested heavily in making health information more widely available to the public by creating on-line, internet-based resources.
This approach to health promotion and education means that information gets to the public quickly at a lower cost and with less impact on the environment than the production and distribution of printed materials. But it assumes that everyone can afford or has access to a computer and internet service, has the ability to use a computer, is motivated to seek health information in this way, and is literate. This policy consequently reinforces socio-economic privilege and perhaps creates privilege amongst those who have computer know-how.
2. In Canada, most doctors’ offices have this type of equipment for conducting pap tests, a screening test for cervical cancer.
All women need pap tests on a regular basis, but women with some types of disability would not be able to use this examination table. As a result, many do not get regular screening for cervical cancer. A policy requiring physicians to use accessible examination tables would promote equity be reducing barriers to care for women with disabilities.
3. Approximately 65% of Canadians have private health insurance, usually through their places of employment. These insurance plans cover the costs of some medications and services such as eye care that are not covered by publicly-funded health insurance.
This situation privileges people who are employed by agencies or companies who can afford to offer them group benefits. Those who are self-employed, unemployed or work for small businesses do not have access to these types of benefits.
4. Some insurance companies have decided that same-sex partners should be eligible for extended health and other benefits.
This policy works to redistribute power and privilege by extending benefits to include sexual minorities.
5. Specialist health care providers and specialized services, such as cancer care, are generally concentrated in large cities.
Centralizing specialized services in urban areas is designed to reduce health care costs, which is good for health care budgets. But it means that those living in cities have a better or easier access to care than people living in rural and remote communities. Some governments have tried to address this inequity by subsidizing the costs of travelling from rural and remote communities to urban centres to receive health care. This approach helps to offset inequity.