Because of social insecurity and marginalization, certain segments of society are deprived of the opportunity to maintain good health. Three of the world’s deadliest infectious diseases – malaria, HIV/AIDS and tuberculosis – disproportionately affect the poorest populations, and in many cases are compounded and exacerbated by other forms of inequality and injustice related to gender, age, sexual orientation or gender identity, and migration status. At the same time, the burden of noncommunicable diseases (often thought to affect high-income countries) is increasingly disproportionately spread across countries and populations with lower incomes and is largely driven by lifestyle and behavioral factors, as well as environmental determinants such as safe housing, water and sanitation that are inextricably linked to human rights.
Focusing on disadvantaged populations also identifies those who are most at risk of poor health and face barriers to accessing quality and affordable health care, including indigenous populations. And while data collection systems are often ill-equipped to collect data on these populations, reports indicate higher rates of mortality and morbidity from non-communicable diseases such as cancer, cardiovascular disease, and chronic respiratory disease among these groups. In addition, laws and policies may target these populations, further marginalizing them and hindering their access to prevention, treatment, rehabilitation and care services.
Human rights violations in health care
Human rights violations or neglect can have serious health consequences. Overt or implicit discrimination in health care – both among health care professionals and between health care professionals and service users – is a powerful barrier to accessing health services and affects their quality.
Mental disorders often lead to attacks on human dignity and autonomy, including forced treatment or institutionalization, and to disregard for the subject’s legal decision-making capacity. Paradoxically, public health still does not pay adequate attention to mental health, despite the high levels of violence, poverty, and social exclusion that contribute to the deteriorating mental and physical health indicators of people with mental disorders.
Not only do human rights violations exacerbate poor health, but for many, including people with disabilities, indigenous people, women with HIV, sex workers, people who use drugs, transgender people and intersex people, health care settings are places where they are at increased risk of human rights violations, including forced treatment or procedures.
Human Rights-Based Approaches
A rights-based approach to health implies a set of clear principles for developing and evaluating health and health care policies and focuses on eliminating discriminatory practices and unfair power relations underlying unfair health outcomes.
In a human rights-based approach, health policies, strategies, and programs must be designed with the specific goal of improving the realization of the right to health for all people, while targeting the most disadvantaged people. The basic principles and standards of a human rights-based approach are outlined below.