Evidence based policy making

Impact on health inequalities still needs to be assessed

Powerful, rich, and well educated people tend to live longer and healthier lives than their less advantaged counterparts. These socioeconomic inequalities in health have been observed in a range of societies—developed, developing, market led, welfare state, and communist. Their expression, however, may vary according to how the particular society is stratified—for example, by income or wealth in the United States, by social class in the United Kingdom, or by education in Europe. They occur across a wide range of causes of death and types of illness, have been observed since accurate statistics were first available, and seem to have been increasing.1

Several governments have recently proposed strategies to reduce socioeconomic inequalities in health.2–5 An issue rendering strategy development in this field difficult is that, although a lot of information is available about the magnitude and causes of socioeconomic inequalities in health, rather less information is available about the effectiveness of policies in reducing them.6 The recent Cross-Cutting review in England noted that intervention research is scanty compared with the much larger body of observational evidence that describes inequalities.5 This is shown by the fact that the review contains six boxed lists, containing between them 50 examples …