Health: what national averages can leave out
· BehindLines newsroom
WHO lists a webinar on 22 October presenting its global report on inequalities in noncommunicable diseases and their risk factors. The event offers a reason to look behind a familiar indicator: the national average.
One figure, different situations
The WHO report notice, dated 20 October, describes gaps in access to prevention and treatment that vary between countries and groups. It also identifies missing comparable data.
An average describes a whole population rather than every member. Imagine two areas with the same overall rate of access to a service. In one, different groups might have similar rates; in the other, some might be served much better than others. This is a fictional illustration of the limits of an aggregate figure, rather than a result from the report.
WHO’s inequality monitoring framework separates measurable differences between groups from the goal of health equity. It describes equity as a state without health gaps that are unfair, avoidable or possible to remedy. Measuring a difference and choosing a response are therefore separate steps to examine.
Connecting data and services
On a page about results from its projects in Latin America and the Caribbean, published in June, the World Bank describes access barriers affecting rural and low-income communities and stresses primary care. That context is not independent confirmation of WHO’s worldwide findings.
Reading this information involves a sequence of questions: which service is being measured, for which population, and over what period? A difference between groups does not establish its cause on its own. A blank entry does not demonstrate the absence of a problem either.
This approach helps distinguish a change in the total from the way that change is distributed. National progress can require closer examination before concluding that every group benefits.
The webinar on the 22nd remains a scheduled event, with no account of proceedings at this stage. Its date is separate from the report’s initial publication. The question is who appears in the figures and who may remain unseen.