Equity on both the scientific and the policy agendas

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7137.1035 (Published 04 April 1998) Cite this as: BMJ 1998;316:1035

WHO report reminds us of the essentials

  1. Louise J Gunning-Schepers, Professor
  1. Department of Social Medicine, Academic Medical Centre, 1105 AZ Amsterdam, Netherlands

    It is time to admit that we need a two pronged approach to equity in health: a scientific and a policy effort. These may not be synchronised and each has to be allowed to run its own course, but they need to happen simultaneously.

    On the one hand we are confronted with a teasing scientific problem. Why are social inequalities in health so universal? They show a clear gradient for almost any health indicator by any measure of social position—be it education, income, professional class, or social class—in every country where data have been collected, irrespective of the country's position on income distribution, access to education, regulations on working conditions, social benefits, or social housing policies. Why do health inequalities appear to affect almost all diseases, both the diseases of poverty and the lifestyle related diseases of more affluent societies?

    Through which more proximal risk factors do socioeconomic factors affect the occurrence and pathophysiology of …

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