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Health inequalities continue to widen

Health inequalities in Britain have continued to increase, despite the government's commitment to tackle the problem, argue researchers in the British Medical Journal.

Inequalities in health widened in the 1980s and 1990s, and the current government has repeatedly expressed its intention to reduce these inequalities. In February 2001 it announced national targets to reduce the gap in infant mortality across social groups and to raise life expectancy in the most disadvantaged areas faster than elsewhere by 2010.

But, say the authors, the new 10-year analysis shows that inequalities in life expectancy have continued to widen in the early years of the 21st century, alongside a general trend of widening inequalities in income and wealth.

Life expectancy continues to rise in the most advantaged areas of the country at a greater pace than in the poorest areas. Among men, for example, the difference between the local authority with the lowest life expectancy (Glasgow City) and the one with the highest (East Dorset) has risen to 11 years. Since Victorian times, such inequalities have never been as high, write the authors.

The Slope Index of Inequality for life expectancy, according to decile of poverty, which the authors argue is a more appropriate measure than the official target, increased from 3.71 in 1992-94 to 3.87 in 2001-03.

Income inequalities also rose markedly in the 1980s and have been sustained throughout the 1990s and into the 2000s, although encouragingly a fall in income inequalities in the most recent time period can be seen. However, income inequalities are such that the poorest 10% in society now receive 3% of the nation's total income, whereas the richest 10% receive more than a quarter.

Wealth (which can be financial, such as savings, or other assets, such as house ownership) is more unequally distributed than income. Since the 1970s wealth inequality has increased, particularly so since 1995-6. Between 1990 and 2000 the percentage of wealth held by the wealthiest 10% of the population increased from 47% to 54%, and the share of the top 1% rose from 18% in 1990 to 23% in 2000.

Wealth inequalities better reflect the accumulation of lifetime (dis)advantage, and the growing inequalities in wealth seen in recent years do not bode well for future trends in health inequalities, say the authors of the BMJ article.

According to the 2002 British Social Attitudes Survey, 82% of people thought the gap between those with high incomes and those with low incomes was too large. Although New Labour has succeeded in raising the living standards of some of the poorest people in Britain, inequalities in wealth have continued to grow and are likely to be transmitted to the next generation, they add.

More substantial redistributive policies are needed that address both poverty and income inequality, they conclude.

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