Guhn – proportionate universality

Proportionate universality is a very interesting concept that speaks to societal solutions, policy solutions to address inequity in our society. So if you think of a socioeconomic gradient, the fact that the haves versus the haves not are doing better or worse on health outcomes it’s related to access to different resources. And generally speaking there are two types of policy tools that you can do. You either provide access and resources for everyone, you give a tax break– you know, like a childcare benefit or some other incentives. You provide public education or you target your intervention to a very specific group that’s specifically in need.  

Proportionate universality relates to the concept that there’s – in principle there is access for everyone to all the resources that we think are necessary like education, access to drinking water, fresh air, play spaces and so forth. But we also acknowledge that in some areas or for some populations facilitating that access is a bit more difficult given the history, given the context, than for others. So proportionate universality means we help everybody but we pay a little bit of extra emphasis on those populations that in our society have been disadvantaged in order to make the access more equitable. There’s different rationales for looking at proportionate universality as a principle or as a policy tool to enhance equity in our society. If you give more to everyone that’s in a way good but it also mean that the differences between the haves and the have nots may remain the same because everybody is lifted up. Also what we have seen in the past is that you provide additional resources, you channel resources into let’s say into child care or to play resources, family support services, often what we’ve seen is that those families that are most advantaged have the best access to make use of those additional resources. For example let’s take child care spaces; some populations may have very, very easy access to them by – due to the fact that they live close to a child care operation. If you don’t have transportation and you don’t – or the childcare facility doesn’t operate during the hours that coincide with your working schedule or they don’t match your cultural value system all of a sudden even though you provide additional resources you may still be excluding or still not facilitating access for certain groups within your population. That’s very commonly seen that even though we think we provide resources that are accessible to everyone unless you address certain barriers that effect some groups more than others like transportation, like scheduling of hours and their cultural barriers and so forth you’re effectually not reaching the entire population and potentially contribute to even more increasing inequities in our society.