Study shows growing inequalities in health in Britain
BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7223.1453 (Published 04 December 1999) Cite this as: BMJ 1999;319:1453
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Yamey calls for redistribution of wealth in order to reduce the
mortality rates among the least affluent classes of society. Since his
"poor" areas already enjoy income levels amounting to 70 per cent of that
of the "rich" areas, what kind of ratio does he suggest as more salutary?
Would 75, or 80, or 85 percent ratio be adequate to erase the extra
mortality? Would anything short of complete levelling of income suffice?
Moreover, since the article by Bosma et al in this issue suggests that excess
mortality has something to do with perceived locus of control, and since
changing this perception would require several generations, how long does
he propose to keep coercive equalization in place before the suggested
benefits are apparent? Would 70 or 80 years do?
Recent Soviet experiment along these lines did not quite work out as
Yamey suggests it should have. Initially, there
was an increase in mortality among the opulent classes, especially in the
precinct of Lyubyanka, which may have done something to equalize mortality
rates. These gains. however, were soon erased by death from starvation of
about 30 million peasants, who were hardly opulent. Today, after nearly a
century of these policies, Russian death rates are still frighteningly
high, quite possibly because the Russian people, after decades of
government tyranny and depredation, have developed the fatalistic attitude
that anything they themselves might possibly do will not matter in the
long run, an attitude which is the chief cause of class related excess
mortality within a single country.
Competing interests: No competing interests
Predictive medicine?
I am not especially interested in party politics but I fail to see
the connection between the increasing health inequalities as reported in
this article and the charges lowered at the Labour government by its
authors. The study from Daniel Dorling and colleagues has been updated
only until 1996, months before Labour came to power.
Labour may or may not have have reneged on its commitments to health
- but in order to demonstrate that we will need data from later years. Or
is this what is meant by predictive medicine?
[I am not a member of, nor employed by, or associated with any
political party.]
Competing interests: No competing interests