Projects per year
Abstract
Health inequalities are the unjust differences in health between groups of people occupying different positions in society. Since the Black Report of 1980 there has been considerable effort to understand what causes them, so as to be able to identify actions to reduce them. This paper revisits and updates the proposed theories, evaluates the evidence in light of subsequent epidemiological research, and underlines the political and policy ramifications.The Black Report suggested four theories (artefact, selection, behavioural/cultural and structural) as to the root causes of health inequalities and suggested that structural theory provided the best explanation. These theories have since been elaborated to include intelligence and meritocracy as part of selection theory. However, the epidemiological evidence relating to the proposed causal pathways does not support these newer elaborations. They may provide partial explanations or insights into the mechanisms between cause and effect, but structural theory remains the best explanation as to the fundamental causes of health inequalities.The paper draws out the vitally important political and policy implications of this assessment. Health inequalities cannot be expected to reduce substantially as a result of policy aimed at changing health behaviours, particularly in the face of wider public policy that militates against reducing underlying social inequalities. Furthermore, political rhetoric about the need for ‘cultural change’, without the required changes in the distribution of power, income, wealth, or in the regulatory frameworks in society, is likely to divert from necessary action.
Original language | English |
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Pages (from-to) | 221-227 |
Number of pages | 7 |
Journal | Health Policy |
Volume | 113 |
Issue number | 3 |
DOIs | |
Publication status | Published - Dec 2013 |
Keywords
- health inequalities
Fingerprint
Dive into the research topics of 'What (or Who) Causes Health Inequalities? Theories, Evidence and Implications'. Together they form a unique fingerprint.Projects
- 1 Active
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Explaining Excess Mortality in Scotland and Glasgow
Collins, C., McCartney, G., Walsh, D., Batty, G. D., Levitt, I. & Taulbut, M.
16/06/08 → …
Project: Research
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Health inequalities, fundamental causes and power: Towards the practice of good theory
McCartney, G., Dickie, E., Escobar, O. & Collins, C., 1 Jan 2021, In: Sociology of Health & Illness. 43, 1, p. 20-39 20 p., 2.Research output: Contribution to journal › Article › peer-review
20 Citations (Scopus) -
The Policy Discourses that Shaped the ‘Transformation’ of Glasgow in the Later 20th Century: 'Overspill’, ‘redeployment’ and the ‘culture of enterprise’
Collins, C. & Levitt, I., 18 Dec 2019, Transforming Glasgow: Beyond the Post-Industrial City. Madgin, R. & Kintrea, K. (eds.). Bristol, UK: Policy Press, p. 21-38 18 p.Research output: Chapter in Book/Report/Conference proceeding › Chapter › peer-review
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History, politics and vulnerability: Explaining excess mortality in a post-industrial Scottish city
Walsh, D., McCartney, G., Collins, C., Taulbut, M. & Batty, G. D., 2 Nov 2016, In: The European Journal of Public Health. 26, Supplement 1, p. 98 1 p.Research output: Contribution to journal › Article › peer-review
Activities
- 1 Invited talk
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“The Political Economy of ‘Excess Mortality’ in Contemporary Glasgow and Scotland”
Chik Collins (Invited speaker)
7 Nov 2016Activity: Talk or presentation › Invited talk
Press / Media
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More progress needed to ensure Scotland embraces sustainability
Chik Collins & Hartwig Pautz
1/07/19
1 item of Media coverage
Press/Media
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Herald follow-up article on research on health in two Ayrshire communities
4/04/16
1 item of Media coverage
Press/Media