The publication of the Black Report over the Bank Holiday Weekend of 1980 by the Thatcher Government signalled the end of the hopes of improvement in public health for twenty years. It was clear that the Government would have preferred to suppress the whole thing, and it is greatly to the authors' credit that this did not happen. However you do not need to read very much to see why the Government wanted to. Redistribution, increased public expenditure and taxation and unashamed socialism are flaunted on almost every page.
Virginia Berridge has given an account of how the report was set up and how the report was written and published.THE BLACK REPORT: INTERPRETING HISTORY .
SHA Conference: The Black Report - 25 Years
On Manchester Friday 9th September 2005
The Socialist Health Association has one of about 260 cheaply produced copies. An updated version was later produced by Penguin books but this is the original text. An attempt has been made to correct typographical errors, which are many, and some of the footnotes have been inserted into the text. The bibliography, appendices and a couple of the tables have not been included.
INTRODUCTION INEQUALITIES AND HEALTH
CHAPTER 1 CONCEPTS OF HEALTH AND INEQUALITY
- Approaches within medicine, epidemiology and sociology
- The choice of indicators of health and ill-health
- Concepts of inequality and social class
- The problems of choosing indicators of inequality
- Conclusion
CHAPTER 2 THE EVIDENCE OF INEQUALITIES IN HEALTH
- The pattern of health inequality in contemporary Britain
- Mortality and morbidity: the sources of data
- Occupational class and morbidity through the life cycle
- Conclusion
CHAPTER 3 TRENDS IN INEQUALITY OF HEALTH
- Decline in death rates
- Morbidity
- Inequalities and distribution
- Conclusion
CHAPTER 4 THE EVIDENCE FOR INEQUALITY IN HEALTH SERVICE
AVAILABILITY AND USE
- GP Consultations
- Hospital Services
- Preventive and promotive services
- Care of the infirm and disabled
- Conclusion
CHAPTER 5 HEALTH INEQUALITIES: INTERNATIONAL COMPARISONS
- Levels of health and changes over time
- Inequalities in health USA - the reduction of inequality?
- Conclusions
Chapter 6 EXPLANATION OF HEALTH INEQUALITIES
Theoretical approaches
Towards explanation of the evidence of health inequalities
Conclusions
CHAPTER 7 THE NEED FOR ADDITIONAL INFORMATION AND RESEARCH
- sources of information relating to health and need for care
- Sources of information relating to use of health services
- Further recommendations
- Conclusion and recommendations
CHAPTER 8 POLICIES TO REDUCE INEQUALITIES OF HEALTH
(1) PLANNING THE HEALTH AND PERSONAL SOCIAL SERVICES TO REDUCE INEQUALITIES:
AND A DISTRICT ACTION PROGRAM
- The definition of objectives and principles
- Planning
- Resource allocation
- A district action programme
- - A programme for 10 special areas
- Conclusion and Summary of recommendations
CHAPTER 9 POLICIES TO REDUCE HEALTH INEQUALITIES;
(2) A WIDER STRATEGY
A A policy for families and children
- Child benefit
- Infant care allowance
- Pre-school education and day care
- Nutrition - school milk and meals
- Accidents to children
- Policy for families and children - costs and a possible source of revenue
B Policy measures affecting households without as well as with children
- A comprehensive disablement allowance
- Working conditions
- Housing
C Towards a coordinated policy in Government for reducing health inequalities
- Conclusion and summary of recommendations
SUMMARY OF REPORT AND RECOMMENDATIONS
APPENDIX I Use of the General Household Survey for the analysis of inequalities in Health.
APPENDIX 2 Gateshead AHA - Health Service Problems 1979
APPENDIX 3 Plans and Priorities for Tower Hamlets1979-1984.
APPENDIX 4 Deaths 1970-72 in Classes IV and V and deaths if rates for Class I had applied (1970-72) England and Wales
APPENDIX 5 General Household Survey Tables
APPENDIX 6 Wealth and Income Tables
APPENDIX 7 The Build up of a revenue target
APPENDIX 8 Resource allocation: Secretary of State's instructions to RHAs. Letters of Feb 1977 and 1978
APPENDIX 9 Illustration of variation in Mortality and hospital admission in
relation to occupational class.
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