BookThe challenge of health inequalities

摘要

Social and economic inequalities are ubiquitous. I read The Impact of Inequality: How to Make Sick Societies Healthier on a recent transatlantic flight. In Washington, DC, I was struck by the plight of the homeless and their improvised cardboard and plastic shelters, all of which were inadequate for the bitterly cold night. From Washington, I flew to Cairo where a sense of history is as pervasive as is the recognition of the very long existence of social and economic inequalities-I found the gender inequalities especially striking.Health inequalities are both offensive and challenging to most health practitioners. Inequalities in death rates, and for most causes of death, are entrenched, start at an early age, persist into old age, are greater in men than women, and, in many countries, are widening. Of course, absolute health inequalities, such as in death rates, are falling in western Europe. This is a major improvement for which public health measures, notably those in response to the cardiovascular epidemics, have made the overwhelming contribution. Nevertheless, relative inequalities between social classes are not changing and in some situations may be increasing. For example, although privileged members of society are able to reduce rates of tobacco consumption, tobacco-induced health inequalities are increasing overall.