Health inequity versus Health inequality – is the distinction really helpful?

I am sure all of you are very familiar with the two aforementioned terminologies and their distinction. The WHO glossary of Health Impact Assessment ( describes health inequalities as the difference in health status or in the distribution of health determinants between population groups. It exemplifies this statement with the scenario of difference in mobility between younger people and the elderly and the different mortality rates among various social classes. Furthermore, they state that some of these differences can be attributed to biologic variations or free choice while some others cannot be. These other differences, that they identify as unnecessary, avoidable, unjust and unfair are what they refer to as health inequities.

As undamaging as this distinction may sound, it allows leeway for interpretation, which when applied to certain other circumstances, say, gender, may cause dilution of the concept. The biologic processes of women like pregnancy and parturition are also the very conditions which lead to possible consequences that are the leading causes of mortality among women. Across the world, there are situations where social norms and cultures and the related conditioning makes it possible for women to accept unhealthy and risky lifestyle as ‘normal or acceptable’. So based on the distinction, would these constitute ‘biologic variations’ and ‘free faulty choices’ or unjust and avoidable differences? Even in the example that they cited, we have to remember the fact that surely not all elderly are mobility restricted. In this context, is this distinction is really helpful and justified?