Table 2: Minority Health and the Right to the Highest Attainable Standard of Health
Examples of Human Rights Violations
- Doctors and health facilities are not located in or in close proximity to marginalized minority neighborhoods.
- Ethnic minority patients are refused treatment, given inferior care, or abused in public health facilities.
- Ethnic minority women lack access to maternal and reproductive health services.
- Social policies disproportionately exclude ethnic minority individuals from access to health insurance.
- Displaced from their lands, ethnic minority have been deprived of their traditional livelihood, and their health has suffered.
|Human Rights Standards||Treaty Body Interpretation|
|ICESCR 12(1): The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.
ICESCR 12(2): The steps to be taken by the States Parties to the present Covenant to achieve the full realization of this right shall include those necessary for: . . . (c) The prevention, treatment and control of epidemic, endemic, occupational and other diseases; (d) The creation of conditions which would assure to all medical service and medical attention in the event of sickness.
|CESCR, General Comment 14: Explaining that “States have a special obligation to provide those who do not have sufficient means with the necessary health insurance and health-care facilities, and to prevent any discrimination on internationally prohibited grounds.” (para. 19).
CESCR, General Comment 14: Explaining that “[I]ndigenous peoples have the right to specific measures to improve their access to health services and care. . . . [D]evelopment-related activities that lead to the displacement of indigenous peoples against their will from traditional territories and environment, denying them their sources of nutrition and breaking their symbiotic relationship with their lands, has a deleterious effect on their health.” (para. 27).
CESRC: Recommending that Israel “ensure unrestricted access to health facilities, goods and services, including urgency treatment, for Palestinians living in the occupied Palestinian territory … [and] to take disciplinary action against checkpoint officials who are found responsible for unattended roadside births, miscarriages, and maternal deaths resulting from delays at checkpoints, as well as maltreatment of Palestinian ambulance drivers.” Also recommending that “the state party should take urgent measures to ensure Palestinian women’s unrestricted access to adequate prenatal, natal and post-natal medical care [and] . . . to ensure the availability and accessibility of psychological trauma care for people living in Gaza, in particular children.” E/C.12/ISR/CO/3 (CESCR, 2011)
CESCR: Calling for the Roma’s inclusion in Serbia’s health insurance scheme. E/C.12/1/Add.108, June 2005, para. 60.
|ICERD 5: State Parties undertake to prohibit and eliminate racial discrimination in all its forms and to guarantee the right of everyone, without distinction as to race, colour, or national or ethnic origin, to equality before the law, notably in the enjoyment of . . . (e) . . . [t]he right to public health, medical care, social security and social services.||CERD: Recommending that Colombia, in close consultation with the affected communities, devise a comprehensive strategy to guarantee that Afro-Colombians and indigenous peoples are provided with quality health care. Also explaining to Colombia that “CERD underlines the importance that targeted measures to improve the standard of living, including improved access to clean water and sewage systems, be linked to health indicators.” CERD/C/COL/CO/14 (CERD, 2009).
CERD: Recommending that the United States “continue efforts to address the persistent health disparities affecting persons belonging to racial, ethnic and national minorities, in particular by eliminating the obstacles that currently prevent or limit their access to adequate healthcare, such as lack of health insurance, unequal distribution of health-care resources, persistent racial discrimination in the provision of health care and poor quality of public health-care services.” CERD/C/USA/CO/6 (CERD, 2008).
CERD: Recommending that the United States “pay particular attention to right to health and cultural rights of Western Shoshone people, which may be infringed upon by activities threatening their environment …” CERD/C/USA/DEC/1 (CERD, 2006).
CERD: Recommending that Estonia “continue to implement programmes and projects in field of health, with particular attention to minorities, bearing in mind their disadvantaged situation.” CERD/C/EST/CO/7 (CERD, 2006).
CERD: Encouraging the implementation of programs to improve Roma health in Lithuania, bearing in mind their disadvantaged situation resulting from extreme poverty and low levels of education. CERD/C/LTU/CO/3, para. 22 (2006).
CERD: Recommending that Guatemala, “in close consultation with the communities concerned, devise a comprehensive and culturally appropriate strategy to guarantee that indigenous peoples are provided with quality health care” and that “the implementation of such a strategy should be ensured by providing adequate resource allocations, in particular for the indigenous peoples and intercultural health unit, together with the active participation of departmental and municipal authorities, compilation of appropriate indicators and transparent progress monitoring “ and that “particular attention should be paid to improving access to health care for indigenous women and children.” CERD/C/GTM/CO/12-13 (CERD, 2010).
CERD: Calling on Romania to guarantee access by Roma to health care and services, and also to social services, and continue to support Roma health mediators. CERD/C/ROU/CO/16-19 (CERD, 2010).
CERD: Finding that, in the United States, wide racial disparities continue to exist in sexual and reproductive health, particularly with regard to the high maternal and infant mortality rates among women and children belonging to racial, ethnic and national minorities, especially African Americans; the high incidence of unintended pregnancies and greater abortion rates affecting African American women; and the growing disparities in HIV infection rates for minority women. CERD/C/USA/CO/6 (2008).
CERD: Urging Norway to “take measures to address the discrimination [of non-citizens] including with regard to access to … health, including the provision of specialized mental and physical health services for traumatized refugees and asylum-seekers.” CERD/C/NOR/CO/19-20 (CERD, 2011).
CERD: Recommending that India “ensure equal access to ration shops, adequate health care facilities, reproductive health services, and safe drinking water for members of scheduled castes and scheduled and other tribes and to increase the number of doctors and of functioning and properly equipped primary health centres and health sub-centres in tribal and rural areas.” CERD/C/IND/CO/19 (CERD, 2007).
CERD: recommending that Panama “ensure that sexual and reproductive health services are available for and accessible to the whole population, and in particular the Kuna community. CERD/C/PAN/CO/15-20 (CERD, 2010).
CERD: Recommending that Chile take measures “to integrate the traditional medicine of indigenous peoples in the state party’s health-care system.” CERD/C/CHL/CO/15-18 (CERD, 2009).
CERD: Recommending that Slovakia “act firmly against local measures denying residence to Roma and the unlawful expulsion of Roma, and refrain from placing Roma in camps outside populated areas that are isolated and without access to health care and other basic facilities.” CERD/C/SVK/CO/6-8 (CERD, 2010).
CERD: Recommending that Mozambique” strengthen its programmes aimed at providing universal access to health care, with particular attention to members of vulnerable groups, including non-citizens and persons without any identification documents, and encourages the state party to take further measures to prevent and combat HIV/AIDs, malaria and cholera.” A/62/18 (CERD, 2007).
CERD: Recommending to Mexico that it “draw up, in close cooperation with the communities concerned, a comprehensive and culturally sensitive strategy to ensure that indigenous peoples receive quality health care. The implementation of the strategy should be guaranteed by an adequate allocation of resources, the collection of indicators and transparent monitoring of progress. Particular attention should be paid to improving access to health care for indigenous women and children. The committee underlines the need for interpreters in this area too, in order to ensure that indigenous people have full access to health services. It is important that the health system recognize, coordinate, support and strengthen indigenous health systems and use them as the basis for achieving more effective and culturally sensitive coverage. The committee requests the state party to provide clear data on maternal mortality and life expectancy in indigenous communities and among people of African descent. Lastly, the committee recommends that the state party step up its efforts to improve the sexual and reproductive health of indigenous women and women of African descent. CERD/C/MEX/CO/16-17 (CERD, 2012).
|CEDAW 12(1): States Parties shall take all appropriate measures to eliminate discrimination against women in the field of health care in order to ensure, on a basis of equality of men and women, access to health services, including those related to family planning.||CEDAW Committee: Noting the Roma women’s marginalization and lack of access to health care and calling upon Macedonia to provide information on concrete projects to address these problems. CEDAW/C/MKD/CO/3, Feb 2006, para. 28.|
|CRC 24(1): States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health.||CRC Committee: Noting the limited access to health services for Roma children in Hungary. CRC/C/HUN/CO/2 (CRC, 2006), para. 41.|