The legacy of apartheid in health and health care

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Abstract
This contribution analyses and systematiscs apartheid as a phenomenon and as a problem in South African health and health care. It is assumed that apartheid is one of the most decisive forces moulding the South African health care system as well as the health of the people, resulting in grave race-related disparities, inequalities, fragmentation and discrimination on the one hand, and divergent, race-related health outcomes in the health indices and health statuses of the different ‘colour’ groups. The material presented. is systematised within a fourfold framework, differentiating between a structural/institutional component and a consequential/outcome component of apartheid, The former refers to both the racially segregated supply system and the racially divided clientele; the latter applies to both structural outcomes in the form of race-related deformities in the organisation and allocation of health care supply and racerelated inequalities and disparities in the health and health status of the different clienteles. The conclusion is that apartheid in health and health care is still firmly in place and will remain a decisive force in South African health and health care for many years. even generations. to come. More deliberate attempts have to be launched to eliminate both ‘apartheid in society’ and ‘apartheid in man’.

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