Equally Well: Report of the Ministerial Task Force on Health Inequalities

ANNEX 2 - PREVIOUS REVIEWS AND REPORTS ON HEALTH INEQUALITIES

Inequalities in health: report of a working party. Black D, Morris J, Smith C, Townsend P. London: Department of Health and Social Security, 1980. www.sochealth.co.uk/history/black10.htm. One of the most influential documents in putting inequalities in health on the agenda. Produced evidence that deprivation and ill-health are inextricably linked and that material deprivation is a major determinant of ill-health and death. Also showed that inequalities in health had worsened in the UK despite the establishment of the NHS in 1948. Inequalities did not result from failures in the health care system, but were due to other social inequalities: income and employment, education, quality of housing, diet and the working environment.

Independent Inquiry into Inequalities in Health: 1998 Acheson report: www.archive.official-documents.co.uk/document/doh/ih/chair.htm. Review to identify priority areas for future policy development with a very significant evidence base to support recommended action. Report found that although prosperity has increased in England, the health gap between social classes had widened since the 1980's, primarily because of the faster rates of improvement in the more affluent groups. Identified 5 areas for action: breaking the cycle of health inequalities, tackling the major killers, improving access to public services and facilities, strengthening disadvantaged communities and supporting targeted interventions for specific groups.

Towards a Healthier Scotland. Scottish Executive 1999. www.scotland.gov.uk/library/documents-w7/tahs-00.htm. Calls for coherent attack on health inequalities, a special focus on improving children and young people's health, and major initiatives to drive down cancer and heart disease rates. Overarching aim to tackle inequalities; specified 3 action levels for better health: life circumstances; lifestyles; health topics.

Tackling Health Inequalities 2002 Cross-Cutting Review: Treasury Review www.hm-treasury.gov.uk/media/B/8/Exec%20sum-Tackling%20Health.pdf. Review to consider how better to match existing resources to health need and to develop a long-term strategy to narrow the health gap. Recommends that tackling health inequalities should be incorporated into priority programmes. Identifies particular groups at risk including: vulnerable older people, vulnerable members of black and minority ethnic communities, people unable to heat their homes, rough sleepers, prisoners and their families, refugees and asylum seekers, looked after children, people with physical or learning disabilities, long-term medical conditions or mental health problems.

Improving Health in Scotland: The Challenge. March 2003. www.scotland.gov.uk/Publications/2003/03/16747/19929. Endorses previous commitments to tackling health inequalities as an overarching aim of the health improvement agenda. Proposes programme to put health improvement initiatives into the mainstream of action, with a special focus on early years, the teenage transition, the workplace and the community.

Securing Good Health for the Whole Population Wanless Report (commissioned by HM Treasury) 2004. http://www.hm-treasury.gov.uk/consultations_and_legislation/wanless/consult_wanless04_final.cfm. Review of the cost-effectiveness and consistency of public health spending decisions, in order to improve health outcomes. Focus on prevention and the wider determinants of health in England. Includes an assessment of the evidence on what interventions work, at what stage they work, and the adequacy of the evidence base.

Measuring Inequalities in Health Working Group. Inequalities in Health. Edinburgh, Scottish Parliament, 2003. www.scotland.gov.uk/library5/health/hirnov03.pdf. Group set up to determine the most appropriate indicators to use to monitor progress in tackling health inequalities. Report concentrates on the measurement of health inequalities between socioeconomic groups. Population groups shown as children, young people, adults and older people. Resulted in 23 explicit targets set in 2004 to reduce health inequalities including smoking during pregnancy, breastfeeding, dental health of children, low birth weight babies, accidents in children, teenage pregnancies, suicides by young men and obesity.

Delivering for Health. Scottish Executive 2005. www.scotland.gov.uk/Topics/Health/NHS-Scotland/nursing/review/so-far/deliveringforhealth. Sets out programme of action for the NHS seeking to shift the balance of care towards a system which emphasises a wider effort on improving health and wellbeing through preventative medicine, through support for self care, and through greater targeting of primary care resources on those at greatest risk, with a more proactive approach in the form of anticipatory care services.

Concepts and principles for tackling social inequalities in health: Levelling up Part 1. World Health Organization. 2006 www.euro.who.int/document/e89383.pdf Concepts and principles for tackling social inequalities in health. European strategies for tackling social inequalities in health: Levelling up Part 2. 2007 www.euro.who.int/document/e89384.pdf Latest evidence about the nature and extent of the problem in Europe; illustrating an approach and policy options to tackle social inequalities in health.

Health in Scotland 2006 Annual Report of the Chief Medical Officer www.scotland.gov.uk/Publications/2007/11/15135302/0. Focus on the significance of the first few years of life as a basis for subsequent health and wellbeing in adulthood. Highlights vital role which education within schools and other settings can play. Violence and impact on health also highlighted.

Inequalities in mortality in Scotland 1981-2001. Leyland AH, Dundas R, McLoone P, Boddy FA. MRC Social and Public Health Sciences Unit Occasional Papers no 16. Glasgow: MRC Social and Public Health Sciences Unit, 2007. www.inequalitiesinhealth.com/. This report combines the use of death records from 1980-2002 with Census data from 1981, 1991 and 2001 to provide a comprehensive picture of the changing patterns of inequalities in mortality in Scotland. It details inequalities by individual socioeconomic circumstances and area deprivation as well as highlighting geographical inequalities. Draws particular attention to widening health inequalities among younger men, due to alcohol, drugs, violence and poor mental health.