“Variations” in health

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7014.1177 (Published 04 November 1995) Cite this as: BMJ 1995;311:1177
  1. Richard G Wilkinson
  1. Senior research fellow Trafford Centre for Medical Research, University of Sussex, Brighton BN1 9RY

    The costs of government timidity

    From time to time researchers working on health inequalities listen with envy to stories from distant lands about open, all party talks organised by governments wanting to know what can be done to reduce inequalities in health. Last year the British government took its courage in both hands and unbarred the door to admit a small deputation of experts to talk about reducing the health divide. Political safety was ensured by limiting the discussion to what the NHS and the Department of Health could do. Poverty, housing, job insecurity, the inner cities, the rationing of health services, and other embarrassing problems were left outside, and the experts agreed to adopt their hosts' view of political correctness by referring to health “variations” rather than “inequalities.”

    Their report, published this week, is a welcome opening of negotiations.1 Although the evidence suggests that health services are not major contributors to health inequalities, the report's recommendations are worth while. As well as saying that health authorities should monitor health variations, target …

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