Understanding Pharmaceuticals and Health Inequalities: An Alternative Approach

Despite the expansion of the global pharmaceutical market, the unprecedented increase in prescription utilization over the last decade, and the critical role of pharmaceuticals in the mitigating suffering and improving survival, social inequalities in health outcomes continue to be a persistent problem in the U.S. and globally. While the public health literature has extensive documentation of social inequalities in health and health care, information on similar inequities in the use of pharmaceuticals is limited. Inequalities in the use of pharmaceuticals, particularly underuse in socially disadvantaged populations, may be an important, yet overlooked, contributor to health inequalities. This information is particularly important for the development of pharmaceutical policies intended to improve access to medicines in these socially disadvantaged populations. This paper will: 1) Discuss the limitations of prevailing approach in measuring inequalities in the use of pharmaceuticals in the U.S.; 2) Present a conceptual framework that illustrates the underlying factors associated with the use of medicines and inequities in their use from a societal perspective; and, 3) Discuss the advantages of population-based pharmaceutical data in advancing our understanding of social inequalities and in developing effective pharmaceutical policies that seek to promote health equity. In addition, this paper will emphasize the importance of incorporating social inequalities in access to prescription medications  into models examining social determinants of health in the US and globally.