Targeting health inequalities.

Graham, Hilary (2001) Targeting health inequalities. The Guardian.

Abstract

Hard on the heels of its election victory, the New Labour government launched a new strategy for public health. The oblique references to "health variations" found in the policy documents of the previous Conservative administration were erased. Inequalities in health were named, shamed and described in detail. White papers followed, confirming that policy was "to narrow the health gap in childhood and throughout life between socio-economic groups". It is an ambitious goal: over the past three decades, rising living standards and increasing life expectancy have been accom-panied not by a narrowing, but by a widening, of these fundamental dimensions. Making the reduction of health inequalities central to public health policy is an important achievement. It puts Britain in step with policy developments in and beyond Europe. But the new health strategies, like the ones which preceded them, are structured around disease outcomes: around reductions in mortality rates for cancer, heart disease, accidents and suicide. Ministers have recently announced health inequality targets for a second New Labour government. Again, they are set around disease outcomes and not the broader inequalities in life chances and living standards which, the government acknowledges, determine health inequalities. My priority for the next government is to set targets for reducing these broader inequalities. The Swedish national health commission has provided a blueprint for such a strategy, setting targets for reductions not in disease and injury, but in exposure to their social determinants. These include income inequality and poverty, selected because they have the "greatest potential" for progress. The New Labour government has taken a first step towards the Swedish model by setting child poverty targets for 2010 and 2020. It opens the way to the development of an equity-oriented public health strategy which, in the words of the government, addresses "the root causes of health inequalities".