Navigation

Health Inequalities: Concepts, Frameworks and Policy - Briefing Paper

Hilary Graham and Michael P Kelly: 2004

At the heart of public health in contemporary Britain is a paradox. Britain is now collectively healthier than it has ever been in its history. Life expectancy improves and some of the great killer diseases are in retreat as the benefits of both a preventive approach to public health and advances in treatment bear fruit. Yet at the same time, the problem of health inequalities remains stubbornly ubiquitous. While the health of the population as a whole may be improving, the health of the least and less well off either improves more slowly than the rest of the population or in some cases gets worse in absolute terms. This is a challenge to policy makers and practitioners. It suggests that while some of our policy and interventions undoubtedly work they also manifestly fail some sections of the population. To sharpen the tools for policy making in this arena, this paper reviews some of the important conceptual problems associated with discussions of health inequalities.

The purpose of this paper is to highlight some of the conceptual issues relating to socioeconomic inequalities in health. The first section discusses how people have been classified in the UK, and how, using the traditional measure of socioeconomic position, the challenge of health inequalities is being addressed. The second section focuses on ‘determinants', a core term in the drive to reduce health inequalities, and discusses the difference between determinants of health and determinants of inequalities in health. The distinction between the idea of health disadvantage, health gaps and health gradients is explored in the third section. The paper therefore makes explicit some of the key terms used in the debates about health inequalities to help inform the process of policy development.

 

This page was last updated: 30 April 2009

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.

Selected, reliable information for health and social care in one place

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.