Summing up Dr James Munro:

Health and inequality: What have I learned?

  • It’s complex!
  • Let’s simplify it as far as possible

But no further

  • This isn’t about health
  • Health inequality isn’t about health
    • It’s about inequality
    • of power and resources
    • causing inequality in health, education, housing, warmth, food, transport and survival
    • Policy must address the source of inequality
    • Not just its effects

This isn’t about poverty

  • Inequality isn’t about poverty or social exclusion
  • Inequality is about in-equality
  • rich and poor
  • more wealthy and less wealthy
  • Policy must address the whole distribution of power and resources
  • Not just the “problem at the bottom”

Inequality is lifelong

Inequality has its effects on health at every point in the life course

  • From before birth to after death
  • Though the earliest effects may also be the longest lasting
  • Policy to ameliorate the effects of inequality must address each part of the life course
  • But especially the start

As Black knew

The income distribution (graph):

Income distribution UK 2003

What has happened:

Gini coefficient 1979-2002

How to make a more unequal society

  • It is easier to make an unequal society than to unmake it
  • Just as it is easier to make
    • a high car society than a low car society
    • or a high gun society
    • or a low trust health service

How to make a more equal society

  • A political problem
  • Many oppose greater equality
  • A practical problem
  • What policies will reduce inequality?
  • Redistribution of power and resources
  • Accessible services
  • Regulation of markets

How can we reduce health inequality without actually reducing inequality?

There has been progress

  • The solution is…
    • Health care? No
    • Public health? No
    • Reducing poverty? No
    • Greater equality?

A simple demand

  • A more equal society please
  • Not a perfect society
  • Not a utopia
  • Just a more equal one
  • Like we had before…?
  • Like the rest of Europe…?The societies in Richard W’s charts are not imagined

Organise around this demand:

  • A clear demand
  • A principled vision
  • An evidence base?
  • Political organisation and alliances will be needed

This should be Labour’s central guiding star

Make the case “Inequality is an obstacle to some kind of greater human harmony”, Richard Wilkinson

How Martin began:

  • Health inequality is “politically invisible”
  • This is the challenge

What do you think?

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