A new book contained an analysis of how geographical perspectives could be used to understand health inequalities. It discussed the geography of health inequality and strategies for reducing disadvantage; reviewed the theoretical basis for a geographical analysis of these problems; and explained how different methodologies in the geography of health, both quantitative and qualitative, could be applied in research.
Source: Sarah Curtis, Health and Inequality: Geographical perspectives, SAGE Publications Ltd (020 7324 8500)
Links: Summary
Date: 2003-Dec
A report described recent health trends in England, and set the context of an ongoing review by Derek Wanless into National Health Service funding. It identified poor lifestyles among low-income groups as a root cause of health inequalities. (In April 2003 Derek Wanless was asked by the government to examine how public health spending decisions were taken, and how to ensure that they could be taken as cost-effectively and consistently as possible, in order to improve health outcomes for any given level of resources. This included an assessment of the evidence about what interventions worked.)
Source: Derek Wanless, Securing Good Health for the Whole Population: Population health trends, HM Treasury (020 7270 4558)
Links: Report (pdf) | HMT press release | Guardian report
Date: 2003-Dec
A paper sought to estimate the effect of new health events on a series of subsequent outcomes that were both directly and indirectly related to socio-economic status. These outcomes included out-of-pocket medical expenses, labour supply, health insurance, and household income.
Source: James Smith, Consequences and Predictors of New Health Events, WP03/22, Institute for Fiscal Studies (020 7291 4800)
Links: Paper (pdf)
Date: 2003-Dec
Senior government advisers said that middle-class people benefited more from the National Health Service than poor people. Those from the professional classes were 40 per cent more likely to get a heart bypass than lower socio-economic groups, despite much higher mortality from heart disease in the deprived group. Poorer people were 20 per cent less likely to get a hip replacement, although they were 30 per cent more likely to need one. Those from the two most affluent social groups got about 10 minutes of a family doctor's time at each visit, while those from the other five groups averaged just over 8 minutes.
Source: Julian le Grand, Anna Dixon, John Henderson, Richard Murray and Emmi Poteliakhoff, Is the NHS Equitable? A review of the evidence, Discussion Paper 11, LSE Health and Social Care/London School of Economics, available from Waterstone's Economist Bookstore (020 7405 5531)
Links: Report (pdf) | Guardian report
Date: 2003-Nov
Researchers sought to understand the relationship between social disadvantage and smoking over the lifetime of adults who had reached their 40s. Preventing social disadvantage at key life stages was found to be as important as directly focused health policies when trying to discourage smoking behaviour.
Source: Christine Power, Hilary Graham and Orly Manor, Socio-Economic Circumstances at Different Life Stages and Adult Smoking, Economic and Social Research Council (01793 413000)
Links: Report (pdf) | Summary (pdf)
Date: 2003-Nov
A report summarised local and community projects in England aimed at tackling health inequalities. Overall, the report demonstrated that tackling health inequalities was not just an issue for the health sector but covered other areas such as education, housing and transport.
Source: Thara Raj (ed.), Tackling Health Inequalities: Compendium, Health Development Agency (020 7430 0850)
Links: Report (pdf)
Date: 2003-Nov
The government announced that local authorities and the National Health Service would be set targets to reduce health inequalities across England. The targets would contribute to rankings in national performance league tables, in a bid to ensure steps were taken to improve the provision of care and support services in deprived areas. The government would publish a progress report using a new set of performance indicators devised by the London Health Observatory.
Source: Speech by Melanie Johnson MP (Minister for Public Health), 30 October 2003, Department of Health (020 7210 4850) | Justine Fitzpatrick and Bobbie Jacobson, Local Basket of Inequalities Indicators, London Health Observatory (020 7307 2824)
Links: Text of speech (pdf) | Guardian report | LHO report (Word file) | LHO webpage
Date: 2003-Oct
An article argued that the introduction of foundation trusts in the National Health Service risked widening inequalities. Safeguards to ensure that equal care was available to everyone who needed it were described as 'insufficient': there were no duties on either foundation trusts or the independent regulator to safeguard the principles of universality and equity. Moreover, it would be the independent regulator, and not local people, who would be responsible for deciding which services were provided where and how.
Source: Allyson Pollock, David Price, Alison Talbot-Smith and John Mohan, 'NHS and the Health and Social Care Bill: end of Bevan's vision?', British Medical Journal 25 October 2003
Links: Article | BMJ press release | Care and Health report
Date: 2003-Oct
A report said that revenues of private hospitals and clinics (excluding National Health Service pay beds) reached an estimated 2,475 million in 2002, up 8.5 per cent on 2001.
Source: Laing's Healthcare Market Review: 2003-2004 edition, Laing & Buisson (020 7833 9123)
Links: L&B press release
Date: 2003-Oct
A report called for a 20mph speed limit on residential roads, which it said could reduce children s deaths and injuries by 67 per cent. It said that the death rate for pedestrian accidents was five times higher for children from the lowest social class compared to those from the highest social class.
Source: Louise Millward, Antony Morgan and Michael Kelly, Prevention and Reduction of Accidental Injury in Children and Older people, Health Development Agency (0870 121 4194)
Links: Report (pdf) | HDA press release
Date: 2003-Oct
Research examined how black and minority ethnic women understood and perceived their identity in the context of access to health services, and assessed the validity of looking at equality and human rights from a multiple identity perspective.
Source: Heidi Safia Mirza and Ann-Marie Sheridan, Multiple Identity and Access to Health: Experience of black and minority ethnic women, Equal Opportunities Commission (0161 833 9244)
Links: Report (pdf)
Date: 2003-Oct
A study investigated how far men were being encouraged to take part in Sure Start local programmes. Staff in a large majority of programmes reported low levels of father involvement in programme activities. But most fathers felt welcomed at services provided by the programmes, and continued to use them when they had seen a positive benefit to themselves or their children.
Source: Nigel Lloyd, Margaret O Brien and Charlie Lewis, Fathers in Sure Start Local Programmes, NESS/SF/004, Department for Education and Skills (0845 602 2260)
Links: Summary (pdf)
Date: 2003-Sep
A new book presented empirical research demonstrating the importance of social disadvantage, throughout the lifecourse, with respect to inequalities in life expectancy, death rates and health status in adulthood; and contained an overview of lifecourse epidemiology as applied to socioeconomic differentials in health.
Source: George Davey Smith (ed.), Health Inequalities: Lifecourse approaches, Policy Press, available from Marston Book Services (01235 465500)
Links: Summary
Date: 2003-Jul
A committee of MPs reported on access to maternity services by women from disadvantaged groups. It said that it had found examples in some areas of excellent practice in meeting the needs of minority ethnic groups, asylum seekers, homeless people, those living in poverty, those from the travelling community and those affected by domestic violence. But it said that good practice was rarely taken up in other areas, or indeed shared across the health service.
Source: Inequalities in Access to Maternity Services, Eighth Report (Session 2002-03), HC 696, House of Commons Health Select Committee, TSO (0870 600 5522)
Links: Report | Guardian report
Date: 2003-Jul
The government published a strategy document on combating health inequalities. It said : 'For too long we have been prepared to tolerate glaring differences in health between different parts of our country and different groups within it'.
Source: Health Inequalities - Programme for action, Department of Health (08701 555455)
Links: Report (pdf) | DH press release | HDA press release
Date: 2003-Jul
A report said that National Health Service charges for prescriptions, glasses, eye and dental health were creeping up and spreading out to hit poor and elderly people, and many with chronic long-term health problems. It called for an urgent and fundamental review of a 'complex, incoherent and unfair' system.
Source: Saranjit Sihota, Creeping Charges: NHS prescription, dental & optical charges - an urgent case for treatment, National Consumer Council (020 7730 3469)
Links: Report (pdf) | NCC press release | Community care article
Date: 2003-Jul
A survey found that the number of people with private medical insurance policies totalled 3,710,000 at 31 December 2002, down 0.3 per cent on the previous year. This followed minor growth in 2000 (up 3.4 per cent) and 2001 (up 1.1 per cent), and a modest upward trend between 1991 and 1999.
Source: Philip Blackburn, Private Medical Insurance - UK market sector report 2003, Laing & Buisson (020 7833 9123)
Links: Summary
Date: 2003-Jul
In England and Wales in 2002-03, 10.31 million sight tests were paid for by the National Health Service. This was 1.6 per cent fewer than in the previous year (10.47 million).
Source: General Ophthalmic Services: Activity Statistics for 2002/03, Department of Health (020 7972 5581)
Links: DH press release
Date: 2003-Jul
In England in 2002, 85.7 per cent of all community prescription items were free to patients, a slight increase on 2001 (85.4 per cent).
Source: Prescriptions Dispensed in the Community, Statistics for 1992 to 2002: England, Statistical Bulletin 2003/12, Department of Health (020 7972 5581)
Links: Bulletin (pdf) | DH press release
Date: 2003-Jul
The first official report was published on the characteristics of Sure Start local programme areas in rounds 1-4, based on the fiscal year 2000-01. Sure Start local programme areas were found to experience some of the worst deprivation in England, with more than double the national averages of low income, unemployment and child poverty. (The first 260 local programmes were rolled out in 4 stages or 'rounds', with each round having approximately 60-70 local programmes.)
Source: Jacqueline Barnes et al., Characteristics of Sure Start Local Programme Areas: Rounds 1 to 4, Department for Education and Skills (0845 602 2260)
Links: Report (pdf) | Summary (pdf)
Date: 2003-Jul
A think-tank report called for a radical overhaul of National Health Service charges. It said free prescriptions should generally be related to ability to pay, with no automatic exemption for pregnant women, nursing mothers or older people; that no one should pay more than about 90 on prescription charges in any one year; and that prescription charges should vary according to the therapeutic value or efficacy of the drug.
Source: A Fairer Prescription for NHS Charges, Social Market Foundation (020 7222 7060)
Links: NPA press release
Date: 2003-Jun
A study found that local authorities in England were already using their new power of health scrutiny to tackle key local health issues. Scrutiny reviews on sex education, teenage pregnancy, smoking in public places and drug use were highlighted. (Local authorities were given the power to scrutinise health issues and services under the Health and Social Care Act 2001.)
Source: Lucy Hamer, Local Government Scrutiny of Health: Using the new power to tackle health inequalities, Health Development Agency (0870 121 4194)
Links: Report (pdf) | HDA press release
Date: 2003-May
A think-tank report said that elderly patients were systematically discriminated against in the National Health Service. It said that the victims of heart disease, stroke and breast cancer died early and unnecessarily in Britain compared with most other western European countries, and that access to care was limited by age.
Source: John Evans, Stephen Pollard, Karol Sikora and Roger Williams, They've had a Good Innings: Can the NHS cope with an ageing population?, Civitas (020 7401 5470)
Links: Summary
Date: 2003-May
An article compared the use of the index of multiple deprivation 2000 with the use of the 'Townsend index' of deprivation as measures of health inequalities. It concluded that the Townsend index remained a reliable measure of health inequalities when compared with the more recent and 'complex' index of multiple deprivation.
Source: Jacqueline Hoare, 'Comparisons of area-based inequality measures and disease morbidity in England, 1994-1998', Health Statistics Quarterly 18, Summer 2003, Office for National Statistics, TSO (0870 600 5522)
Links: Article (pdf)
Date: 2003-May
The High Court ruled that people with learning difficulties should receive the same medical treatment as everyone else. It said that a hospital had been wrong to deny life-saving medical treatment to a patient who had kidney failure, on the basis that he had autism. It said that not providing satisfactory medical treatment was contrary to the rights of a mentally incapacitated patient under United Kingdom and European law.
Source: An Hospital NHS Trust v. S., D.G. and S.G., High Court judgement, Court Service (020 7210 2266)
Links: Text of judgement | Community Care article
Date: 2003-Mar
A study investigated the impact on policy-making of the Independent Inquiry into Inequalities in Health (the Acheson Inquiry ) since its publication in 1998. It identified three main gaps: a lack of mechanisms to promote and ensure progress in policies to tackle health inequalities; a need for independent, regular evaluation of the progress of policies and their impact; and a need to conduct and collate research studies on effective interventions and outcomes.
Source: Mark Exworthy, Marian Stuart, David Blane and Michael Marmot, Tackling Health Inequalities since the Acheson Inquiry, Policy Press for Joseph Rowntree Foundation, available from Marston Book Services (01235 465500)
Links: JRF Findings 363 | Acheson report
Date: 2003-Mar
Statistics on the health of people in England in 2001 were published. A survey interviewed over 15,600 adults and nearly 4,000 children in private households The proportion of adults eating five or more fruit and vegetable portions a day increased steeply as household income increased. The proportion consuming five or more portions a day was lowest among those aged 16-24, and increased with age to a peak among those aged 55-64. 18 per cent of men and women aged 16 or over reported having one or more of five types of disability: 5 per cent of adults had a serious disability.
Source: Madhavi Bajekal, Paola Primatesta and Gillian Prior (eds.), Health Survey for England 2001, Department of Health, TSO (0870 600 5522)
See also: Journal of Social Policy Volume 31/3, Digest 123, paragraph 12.4
Date: 2003-Jan
