Tackling inequalities in health

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6988.1152 (Published 06 May 1995) Cite this as: BMJ 1995;310:1152
  1. Johan P Mackenbach
  1. Professor Department of Public Health, Erasmus University, Rotterdam, Netherlands

    Great need for evidence based interventions

    What can be done about socioeconomic inequalities in health? A report by the King's Fund contains an impressive agenda for action.1 The objective of the report was “to outline a number of practical and affordable ways in which the situation could be substantially improved, if the political will existed to recognise that tackling inequalities in health is a fundamental requirement of social justice for all citizens.”

    The report identifies four areas for intervention: the physical environment, social and economic factors, barriers to adopting a healthier personal lifestyle, and access to appropriate and effective health and social services. For each area one factor has been selected to illustrate possible policy initiatives: housing, income maintenance, smoking, and access to health care. The initiatives range from the development of innovative health education programmes to investments in social housing (to be financed by, among other things, the abolition of tax relief on mortgages) and from ensuring an equitable allocation of NHS resources to changes in the tax system (for example, an increase in the highest rate of income tax).

    This brief summary of the report cannot do justice to the richness of its ideas. This richness makes the report a welcome complement to a lucid but much thinner discussion paper by the World Health Organisation that was …

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