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Inequalities in health

BMJ 1999; 319 doi: (Published 31 July 1999) Cite this as: BMJ 1999;319:319

Policies to reduce income inequalities are unlikely to eradicate inequalities in mortality

  1. Pekka Martikainen, Research fellow,
  2. Tapani Valkonen, Professor
  1. Population Research Unit, Department of Sociology, PO Box 18, FIN-00014, University of Helsinki, Finland
  2. Founders' Network, Canadian Institute for Advanced Research, Toronto, Ontario M5V 3A8, Canada

    EDITOR—In their editorial Davey Smith et al welcome the report of the independent inquiry into inequalities in health but criticise it for not sufficiently tackling the underlying causes of health inequalities, which they see as following from inequalities in wealth, material resources, and especially income.1 As partial evidence they refer to the simultaneous increase in income inequalities and social inequalities in mortality in Britain over the past 20 years.

    The role of income inequality as the fundamental cause of health inequality may not be as evident as these authors claim. A recent comparative study in the European Union on social inequalities in health among men indicate that the association between income inequality and inequalities in health is weak. For example, in four Scandinavian countries—Finland, Sweden, Norway, and Denmark—social inequalities in morbidity and mortality are roughly comparable to or larger …

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