Inequalities in Life and Death: What If Britain Were More Equal?

Inequalities in Life and Death: What If Britain Were More Equal?

Inequalities in Life and Death: What If Britain Were More Equal?

Inequalities in Life and Death: What If Britain Were More Equal?


This follow up report to Death in Britain (Joseph Rowntree Foundation, 1997) - a study of changes in death inequalities from the 1950s to the 1990s - contains further evidence of the widening geographical gap in mortality in Britain, but shows how this gap might be narrowed through social and economic policies. The Death in Britain report claimed that Britain was failing to reach Target One of the World Health Organisation - to reduce inequalities in health by 2000. Inequalities in life and death provides conclusive evidence that Britain has failed to reach that target and argues that this failure need not continue.The report presents research which shows what the effect on mortality would be, in terms of actual numbers of lives saved, if full employment were achieved, child poverty eradicated and material inequalities reduced. The geographical analyses are primarily based on parliamentary constituencies.Inequalities in life and death:illustrates and explains Britain's changing geographical pattern of mortality;explains the role played by age, gender, social class and employment status in producing geographical inequalities in mortality;explains the impact of changes in social injustice throughout the 1980s and 1990s;demonstrates the potential impact of current policy in tackling health inequalities. The evidence is clearly portrayed with extensive use of full-colour maps and graphs. This report is essential reading for policy makers, academics and all those interested in reducing inequalities, particularly with respect to health policy.



It has long been known that the circumstances in which people live and the manner in which society is organised affect how and when people die. the patterns of inequality in life expectancy between different places are not a matter of chance or fate, but a reflection of the stuff of life itself. This inequality is often referred to as ‘the gap’ – between rich and poor and, in Britain, between ‘North’ and ‘South’. This report looks at change in those patterns of inequality – change which has occurred in recent times and change which might be brought about if current government policies succeed in making life in Britain more equal. the future is considered first, with analysis of the past and then methodological explanations following. the report’s underlying theme is identification of the factors which account for patterns of inequality, and how these might be used as levers with which to narrow that ‘gap’.

To begin, the report estimates the effect on death rates if life in Britain were changed through successful government policy initiatives. Each policy examined is a real and current one. This is not a ‘blue sky’ report; it is based on changes to life in Britain which may be happening now. Specifically, the report estimates the effects on inequalities in health of achieving full employment, of eradicating child poverty and of some modest redistribution of income. the effects of these changes are considered for the nation as a whole and on the constituency-level pattern of mortality. the report shows how big the reward for the effective implementation of progressive social policy might be. This, after all, is a government which wants to tackle ‘the worst inequality of all’: inequality in health (Dobson, 1997). These results can be found in Chapter 2.

The rest of the report takes a step-by-step approach to explaining contemporary inequalities in mortality, explaining how those inequalities have developed over time, and showing how policies of the past are implicated in those changes. the report explores the importance of social change on the pattern of premature mortality. It determines the extent to which changes that took place in society during the 1980s and early 1990s are responsible for the widening of inequalities in health seen now, and for changes in the geographical pattern of good and poor health. in particular, the report asks: in which places, and on which (social and demographic) groups did social change have most effect? Which factors best account for the changes in the geography of mortality over the period?


The geography of mortality in Britain is well known, with higher death rates in the North and Scotland and in the inner areas of larger cities. Associations between the chances of an individual dying and their age, gender, social class and employment status are also quite clear. However, the way in which these demographic, socioeconomic and geographic factors interact to create the geography of mortality is less clearly understood.

Understanding the impact of social factors on health is important in an environment where political emphasis has been placed on reducing inequality, unemployment and child poverty. Levels of inequality and unemployment are largely the result of long-term government policy, albeit set against the background of a shifting global economy. This report shows how the cost of policy success or failure can be estimated in . . .

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