What are the causes?

doi:10.1136/bmj.39262.449468.3A

BMJ 2007;335:8 (7 July), doi:10.1136/bmj.39262.449468.3A

Letters

Tackling health inequality

What are the causes?

The first 150 words of the full text of this article appear below.

Heath demands that we "get tough on the causes of health inequality."¹She seems to imply that it's a rich-poor thing, a widening ofthe gap between haves and have-nots.

But why exactly is the United Kingdom 21st out of the 27 EuropeanUnion countries? Is it because we stand side by side with theUnited States and are increasingly embracing privatised health?Is it because we have an archaic feudal society? Is it becauseour expansionist past is finally catching up with us? Well,I don't know, and my guess is that none of us does and so ifwe choose, as Heath suggests we should, to "pursue politicalanswers alongside technical ones" we are reduced at best tonibbling around the edges of something that is so large thatit has neither form nor shape.

Real change requires inspirational leadership that is strongand sustained. It will also . . . [Full text of this article]

James N Hardy, principal general practitioner

Bethnal Green Health Centre, London E2 6LL

jim.n.hardy@dsl.pipex.com