Wednesday, December 14, 2005

you're poor, you're ill and you won't live long

Health inequalities increased between rich and poor areas in Britain during the 1980s and 1990s. The current government has done nothing to reduce these inequalities. In fact inequalities in life expectancy, income and wealth have widened during their administration.

Twenty years ago, the World Health Organization set up Health for All 2000. 38 targets were set out to reduce inequalities in health. The main aims were;

Ensuring equity in health by reducing gaps in health status between countries and between population groups within countries.
Adding life to years by helping people achieve, and use, their full physical, mental, and social potential.
Adding health to life by reducing disease and disability.
Adding years to life by increasing life expectancy.

Recent studies have shown that the Health for All aim of reducing inequalities between groups of the population failed abysmally. In fact, the opposite occurred.

In 1997 Frank Dobson, the then secretary for health, stated, “Inequality in health is the worst inequality of all. There is no more serious inequality than knowing that you’ll die sooner because you’re badly off.”

Hazel Blears, prior to her becoming the Home Office's chief police state protagonist, said, “Tackling health inequalities is a top priority for this government.”

In 2001 two national targets for 2010 were announced;

To reduce the gap in infant mortality across social groups, and
To raise life expectancy in the most disadvantaged areas faster than elsewhere.

However, new data shows increases in health inequalities in the early years of the 21st century in the UK. Life expectancy continues to rise in the most advantaged areas of the country at a greater pace than in the poorest areas.

Income inequality has remained at its greatest for the last 20 years. These record level inequalities began in the 1980s and have continued throughout the 1990s and into the 2000s. The poorest 10% in society now receive a mere 3% of the nation’s total income, whilst the richest 10% receive more than a 25%. Income inequality is not the whole story though.

Wealth is even more unequally distributed than income. Wealth reflects lifelong circumstances, and can include savings, and other assets such as house ownership. Increasing inequality in wealth began in the 1970s, and has widened particularly since 1995-6. From 1990 to 2000 the wealthiest 10% of the population increased its share of the national wealth from 47% to 54%. The top 1 percent's share rose from 18% in 1990 to 23% in 2000. In the ten years up to 2003, housing wealth for the richest 10% of children increased by 20 times more than that for the poorest 10%.

For some health outcomes there will be a delay in terms of the effect of material circumstances. The full effects of current income inequalities on health may not be immediately visible. Wealth inequalities, however, reflect the accumulation of lifetime dis/advantage. The growing inequalities in wealth hold little hope for future trends in health inequalities, they will be transmitted to and magnified among future generations.

(Reference: Health Inequalities and New Labour: how the promises compare with real progress. Mary Shaw, George Davey Smith, Danny Dorling. Published BMJ 30 April 2005)

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