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I read the paper by Dorling et al (BMJ 2000 321 1547-1551)with
interest. May I as a humble retired anaesthetist, unversed in the
science of human geography, pose some simple questions?.
Redistribution of income appears to be advocated as some kind of
1. Redistribution of income is not a new concept in Britain. It
was practiced to varying degrees by both major political parties during
the third quarter of the past century. It is disappointing to find no
improvement in the health of those who should have benefited from this
policy during their formative years.
2. The predominant common factor in the health hazards quoted would
seem to be that they are smoking-related. Is there any evidence to
suggest that additional income would reduce the consumption of tobacco
among those at the lower end of the social spectrum?. Experience to date
would seem to suggest that it would simply provide a windfall for the
3. As indicated in Dorling's paper it is improbable that the same people
were assessed in both the 1896 and 1991 surveys. The really interesting
challenge would, therefore, be to identify the inherent or acquired
characteristics which select individuals or groups who gravitate to the
least desirable areas.
The 64 thousand dollar question is the degree to which these factors
can be modified by redistribution of income.