The Measurement of Inequality in Health

Abstract

Wherever reliable statistics exist, even in relatively prosperous and egalitarian societies, such as the countries of Scandinavia, they show that persons from poorer social strata and environments have higher death rates than their better-off peers (Kohler and Martin, 1985; WHO, 1986). In the countries of Western and Southern Europe, death rates have fallen over many decades and the expectation has been that the fall would be greatest in those socio-economic groups with the highest death rates, leading ultimately towards an equalisation of rates of death and age at death. In Britain, the National Health Service and the Welfare State were created largely to achieve that objective — along with its correlates of better health and an enhanced quality of life. For reasons of both social equity and of effectiveness in the funding and administration of our health and related social services, it is crucial to know how far equalisation of mortality between individuals and groups has been achieved.