Four: Tackling health inequalities


Much of the evidence on the relationship between income and health seems to point to a non-linear relationship, at least at the individual level, indicating that the association is much stronger when income is low (Deaton, 2003). Whether it is absolute income, or poverty, that matters, rather than relative income, or rank, a non-linear relationship with health indicates that reducing income inequality will improve overall health, as the health gain enjoyed by the worse off outweighs the deterioration suffered by the better off. Moreover, when a country reaches the level of wealth at which average income has negligible effects on overall health, improvements could still be achieved by reducing income inequality. And this is independent of any direct effects that income inequality may have on health (Wilkinson, 1996). The evidence would appear to strongly support the case for redistributive policies, and for policies to fight poverty, in a country like the UK. This would not just improve the health of the worse off, and likely reduce inequalities, but it would also improve overall population health. However, redistribution tends to produce its effects in the long term, and may have an opportunity cost in terms of reduced growth and average income. In the short term, health policy measures to improve the health of the worse off tend to require disproportionately large investments, and measures generally aimed at improving population health tend to have a greater effect on the better off, making the simultaneous achievement of a narrowing of inequalities and of an improvement in overall health difficult, if not impossible.

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