British government looks at effects of wealth on healthBMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6939.1257 (Published 14 May 1994) Cite this as: BMJ 1994;308:1257
- T Delamothe
The British government is to examine the links between social inequalities and health as part of its continuing review of the Health of the Nation targets. This comes after more than a decade of official reluctance to discuss the issue.
A new interdepartmental working group will be chaired by Dr Jeremy Metters, deputy chief medical officer, who announced the formation of the new group at a conference on social inequalities and health organised by the BMA and the European Public Health Alliance. In a message welcoming the conference Mrs Virginia Bottomley said: “The reason for variations in health are likely to be the result of a complex interplay of biological social, environmental, cultural, and behavioural factors. We need a better understanding of how these factors interrelate and at what points it is possible to undertake effective interventions.”
The two day conference, attended by over 100 participants from 16 countries, came up with numerous suggestions for interventions. These included directly attacking the socioeconomic factors most closely associated with poor health - such as low income, unemployment, and low educational achievement - and actions aimed at factors that may mediate the effects of low income - such as poor housing and access to nutritious, affordable food.
The importance of national economic policies to health emerged as one of the key themes of the conference. Policies on taxation, employment, and social security benefits are all likely to affect people's socioeconomic circumstances. “Economic policy is therefore an important and legitimate part of public health,” said Dr Mel Bartley of the University of London.
A much closer collaboration between public health activists and economists may be one of the conference's most important legacies. Evidence from the rapidly developing countries of south east Asia suggests that economic growth does not have to increase social inequality. “Integration of the public health view with that of economists is not possible,” said Professor Johan Mackenbach of the Erasmus University in the Netherlands.
Professor Louise Gunning-Schepers of the Institute of Social Medicine, Amsterdam, said, in summing up the conference, that a common methodology to evaluate interventions for reducing inequality was urgently needed. She also repeated the hope that in future such conferences would include participants from socially disadvantaged groups.
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