Intended for healthcare professionals

Letters Social determinants of health

Inequality is hidden in plain sight

BMJ 2021; 372 doi: (Published 21 January 2021) Cite this as: BMJ 2021;372:n169
  1. John Robson, reader1,
  2. Alexander Miller, public health analyst2,
  3. Jayne Taylor, public health consultant2,
  4. Kambiz Boomla, senior lecturer1,
  5. Sally Hull, reader1,
  6. Carol Dezateux, professor of epidemiology and health data science1
  1. 1Institute of Population Health Science, Queen Mary University of London, London E1 2AT, UK
  2. 2City of London Corporation and Hackney Council, London E8 1DY, UK
  1. j.robson{at}

We agree with Moscrop and colleagues that socioeconomic inequalities are being hidden in plain sight by area based “averaging” of social disadvantage, which blunts social gradients and conceals pockets of disadvantage like hostels or homeless people.1 Area based scores such as the index of material deprivation (IMD) are important tools, but they lack resolution at an individual level, particularly where the urban or …

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