Abstract
Inequality is historically known to impact negatively on poverty reduction and economic growth. It is also known to accentuate inequality and perpetuate differentials in access to resources providing health, education and employment opportunities. Therefore, inequality of any nature and form needs to be examined, evaluated and addressed to initiate and propel positive changes. Endemic poverty, unemployment, lack of sanitation and safe drinking water; and effective healthcare determine as much as produce inequalities. The labyrinth of social relations and institutions often result in the exclusion of certain social groups on the basis of identities like gender, caste, ethnicity, region and religion. This perpetuates inequality induced marginalization and discrimination affecting access to services, goods and resources which restrict knowledge acquisition and skill development. Social exclusion, however, does not necessarily equate to poverty. Although, there is a strong correlation between socially excluded groups and high levels of poverty which influence health and its correlates. In this unequal world, there are ‘privileged’ and ‘underprivileged’ groups whose status is determined by the conducive environment for propensity to access resources and avail opportunities. A discussion on inequality in the global and national context, and how inequality affects access further perpetuating exclusion, is imperative at this time when the pandemic COVID-19 has opened new dimensions of deliberation. This paper explores the prevailing inequalities and their impact on access to healthcare in general, and vulnerabilities of people engaged in works related to cleaning and cremation.
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Notes
- 1.
Expert Group to Review the Methodology for Measurement of Poverty, also known as the Rangarajan Expert Committee, was set up by the then Planning Commission to review the poverty levels indicated by its predecessor, the Tendulkar Expert Committee that yielded very low rural and urban poverty lines.
- 2.
Dalberg Advisors (2017). Understanding Indian sanitation workers, and finding solutions for their challenges. https://dalberg.com/our-ideas/understanding-indian-sanitation-workers-and-finding-solutions-their-challenges/.
- 3.
Based on an informal discussion at Lodhi Road Crematorium with a worker handling the corpses on 26 April 2021.
- 4.
Based on the narrative from cremation workers at Nigambodh Ghat. Delhi on 6 May 2021.
- 5.
The ‘nudge’ concept was popularized in the 2008 through the book’ Nudge-Improving Decisions About Health, Wealth and Happiness’ authored by the behavioural economist Richard Thaler and legal scholar Cass Sunstein, University of Chicago.
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Acharya, S.S. (2022). Inequality and Exclusion in Access to HealthCare: Learning from the Pandemic. In: Acharya, S.S., Christopher, S. (eds) Caste, COVID-19, and Inequalities of Care. People, Cultures and Societies: Exploring and Documenting Diversities . Springer, Singapore. https://doi.org/10.1007/978-981-16-6917-0_14
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