Mapping the historical causes of health inequalities

 

Health inequalities: critical perspectives.

Smith KE, Bambra C, Hill S, editors. Oxford University Press; 2015 (£40.49; 352 pp). ISBN 9780198703358

 

Health inequalities: critical perspectives is a well written and very readable book that maps the history of health inequality research and thinking over the past 40 years. The book’s editors and chapter authors represent key current and emerging national and international contributors to the field of health inequalities research. Together, they contribute to a comprehensive discussion of the successes, challenges and new directions needed to meet the ongoing challenges of persistent health inequalities. Although the book draws heavily on experiences from the United Kingdom, it is relevant for an international audience, particularly for those with similar political and health systems, such as Australia.

Beginning with the Black report of 1980,1 this book documents the history of health inequalities research during a period that also saw governments adopt conservative social and economic policies dominated by neoliberal ideals. The mapping of the tensions between upstream and downstream intervention and responsibility is shown throughout the book. Well worked examples, such as the chapter analysing recent economic downturns with associated austerity measures that unevenly affect lower income people (chapter 12) or the chapter describing the roles of large corporations as drivers of inequalities (chapter 13), provide new insights into the concerns raised.

Health inequalities: critical perspectives deals with the reasons for the general failure to reduce health inequalities over this 40-year period. It makes a strong case for ways forward, such as engaging partners within the broader social and political system to debate the upstream drivers of health inequalities and their role in maintaining these inequalities; expanding research opportunities and undertaking social experiments to test the impact of proposed policy interventions; and finding ways to work with communities that are most affected by health inequalities. Finally, the book challenges readers to learn from successful public health campaigns and become smarter advocates for policies to reduce health inequalities.

This book makes a significant and timely contribution to understanding the field of health inequalities, which is particularly salient today. Health inequalities: critical perspectives would be a valuable reference for researchers, policy advisors, health practitioners and students, in fact, for anyone with an interest in social equality.