The World Health Organization’s Commission on Social Determinants of Health published its hard hitting and well received report in mid-2008 with the stark message that “social injustice is killing people on a grand scale.”1 2 The commission’s chair, Michael Marmot, was promptly invited by the UK prime minister and then health secretary for England to consider the implications for health inequalities in England, with a view to informing the government’s post-2010 strategy for tackling them. Fresh thinking and renewed momentum were needed in the face of mounting evidence that the 2010 inequalities targets would not be met.3 The government’s national equality panel has since concluded that inequalities in earnings and incomes are high in the United Kingdom compared with other industrialised countries.4 Economic advantage and disadvantage reinforce themselves across the life cycle.

The Marmot review team submitted its final report to ministers in December, marking the end of a frenetic period of activity involving nine task groups, three working committees, and two interim reports.5 The timing has eerie echoes of the groundbreaking 1980 Black report.6 Although the review chaired by Sir Douglas Black was set in motion by a Labour government, it reported to a Conservative one that was distinctly cool on the subject of health inequalities.

The Marmot report may avoid a similar fate: an election is some months away and all political parties have affirmed …