CHPR Blog February 2019 – Louise Warwick-Booth
Social inequality is a pervasive issue across all societies globally, and there is a large and ever-growing evidence base detailing the myriad of ways in which it exists. UK inequality levels are high compared to many other countries and this is negative for all of us – even for those who are wealthy see https://www.equalitytrust.org.uk/ for more discussion of this.
UK media reports frequently illustrate the many areas in which inequalities exist. The BBC reported on high school performance last month, and if you explore the data you can see the differences between schools, and pupils in terms of attainment with some doing much better than others. Poorer pupils have the worst educational attainment https://www.bbc.co.uk/news/education-46947617. During 2018, news reports frequently covered gender inequality. Stories of disadvantage, sexual harassment and abuse experienced by women and girls continue to be detailed. The #metoo campaign has raised awareness of these issues but can be debated in terms of how effective it might be in bringing about change https://www.bbc.co.uk/news/world-44045291. Global inequalities also feature regularly in many news reports– poverty, war, famine, climate change and the sustainability of the planet – all of which affect health. Health inequalities are again well evidenced, and lead to large differences in life expectancy. Recent progress in increasing life expectancy in the UK has stalled https://theconversation.com/improving-life-expectancy-used-to-be-the-uks-forte-now-its-falling-behind-101573, a concerning trend. There are many social determinants of health linked to broader inequalities, which is why we use a social model of health to underpin our research and teaching, and this too has received media attention as discussed in one of our 2018 blogs https://chprblog.wordpress.com/2018/08/29/the-emergence-of-the-social-model-of-health-on-television/
Social policy approaches sometimes aim to improve health and address inequalities, for example, the UN’s Sustainable Development Goals (https://www.un.org/sustainabledevelopment/sustainable-development-goals/) are a global attempt. There are identified areas where policy can also be directed to improve health, based upon existing research evidence http://www.instituteofhealthequity.org/resources-reports/fair-society-healthy-lives-the-marmot-review. However, some policy approaches can worsen inequalities and be detrimental to the health of populations. UK austerity policy has been negative for the most vulnerable groups according to some research https://academic.oup.com/eurpub/article/27/suppl_4/18/4430523. Brexit too may also have an impact upon inequalities that is yet to be fully understood, time will of course tell.
From this brief discussion so far, social inequality is clearly a complicated and multi-faceted area, with many social divisions and intersections at play. I have recently updated an introductory text book to this broad area:
In doing so I was reminded of the complexities associated with inequalities, debates about the evidence and the many outstanding challenges (locally, nationally and of course globally). Despite improvements (it is not all negative – https://www.wvi.org/united-nations-and-global-engagement/article/were-mdgs-success), much needs to be done to make the world a more equal and socially just environment – an aim that would result in significant health improvements for us all.