![]() ![]() The Inverse Care Law is explained and the Inverse Response Law illustrated through four case studies: the 2017 Grenfell Tower disaster in London, the 2016 Kaikoura earthquake in North Canterbury, New Zealand, Hurricane María in Puerto Rico, 2017, and early warning systems surrounding the Central Mexico Earthquake of 2017.Īs disasters are “increasing in frequency, scale, cost and severity”, impacts on communities are exacerbated. Drawing upon the key public health principles within the Inverse Care Law, this paper proposes an Inverse Response Law that relates to the social construction of disaster risk as well as access to resources in the aftermath of a disaster event. The resulting vulnerabilities are then magnified post disaster through systematic differences in terms of access to resources. These inequities are driven by economic and social policy as well as institutional decision-making. ![]() In the field of disaster risk reduction, consideration must be given to the ways in which inequities create vulnerabilities prior to a disaster. The law may also be applied in the context of access to health care in the weeks and months following a disaster as people who are most in need of medical services are least likely to receive them. The Inverse Care Law draws attention to the role of policy makers in influencing the distribution and quality of health care and related infrastructure. The law considers how health care markets create inequities in access to services through privileging certain groups and disadvantaging others. Tudor Hart’s Inverse Care Law refers to the idea that people who require the most care actually receive the least and to a lesser standard. Case studies from recent disasters, in London, New Zealand, Puerto Rico and Mexico City are examined in order to illustrate themes at work relating to the Inverse Response Law. In this article, the Inverse Care Law is outlined, its application to medical treatment following disasters considered and an explanation of the Inverse Response Law provided. ![]() Both the Inverse Care Law and the Inverse Response Law focus on the structural organisation of services at a macro level. In a market model of recovery, vulnerable groups struggle to compete for necessary services creating inequities in adaptive capacity as well as in social and wellbeing outcomes over time. Drawing on key principles within the Inverse Care Law, the Inverse Response Law refers to the idea that people in lower socio-economic groups are more likely to be impacted and to experience disparities in service provision during the disaster response and recovery phase. The fields of disaster risk reduction need to consider the ways in which inequities, driven by economic and social policy as well as institutional decision-making, create vulnerabilities prior to a disaster, which are then magnified post disaster through entrenched structural differences in access to resources. The Inverse Care Law is principally concerned with the effect of market forces on health care which create inequities in access to health services through privileging individuals who possess the forms of social capital that are valued within health care settings. ![]()
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