A Socio-Legal Study on Health Disparities in Punjab: Structural Inequities, Legislative Gaps, and Pathways to Equitable Healthcare

Abstract

Health disparities in Punjab represent a persistent intersection of socio-economic stratification, caste-based exclusion, gender inequality, and systemic legislative inadequacy. This paper undertakes a rigorous socio-legal analysis of the multi-dimensional health inequities experienced across Punjab's diverse population strata, examining the structural determinants that sustain unequal health outcomes. Drawing on secondary data from the National Family Health Survey (NFHS-5, 2019-21), the Punjab Economic Survey (2022-23), district health bulletins, and a systematic review of legal instruments governing public health, this study identifies critical gaps between constitutional health entitlements and on-ground realities. The analysis reveals persistent rural-urban divides in healthcare access (90% urban versus 68% rural), elevated infant mortality rates in Scheduled Caste-dominated districts such as Faridkot (40 per 1,000 live births), and inadequate enforcement of the National Health Mission mandates at the sub-district level. The paper critically evaluates the performance of the Clinical Establishments (Registration and Regulation) Act, 2010, the Mental Healthcare Act, 2017, and the Punjab Health Systems Corporation Act under conditions of institutional underfunding. It argues that achieving substantive health equity requires legislative reform aligned with the right to health as a justiciable constitutional right under Article 21, alongside inclusive public health governance incorporating marginalized community participation. The study contributes original empirical-analytical insights to the literature on health law, social justice, and public policy in the Indian federal context.