The International Handbook of Suicide Prevention: Research, Policy and Practice

By Rory C. O’Connor; Jane Pirkis | Go to book overview

15
Inequalities and Suicidal Behavior

Stephen Platt


Introduction

Health inequality refers to the “systematic and avoidable differences in health outcomes between social groups such that poorer and/or more disadvantaged people are more likely to have illnesses and disabilities and shorter lives than those who are more affluent” (Judge, Platt, Costongs, & Jurczak, 2006, p. 11). As Mackenbach (2006) has shown, the problem of health inequality is universal. Those lower down the socioeconomic hierarchy, whether measured in terms of economic position (e.g., being unemployed or workless), occupational status (e.g., routine and manual occupations), income level (e.g., living in poverty), or educational attainment (e.g., without qualifications), are at greater risk of morbidity and premature mortality than those higher up the hierarchy. The persistence of large health inequalities, even in countries with long-standing social, health care, and other policies aimed at creating more equality in welfare, highlights their deep roots in the social stratification systems of modern societies.

As a result of growing international recognition of the importance of health inequalities and consensus about their unacceptability (inequality as inequity, i.e., differences in health outcomes that are “unnecessary and avoidable as well as unjust and unfair”1), the goals of public health policy, particularly in post-industrial Western countries, have widened.

A narrow concern with promoting population health is giving way to a broader vision of
the goals of policy. The broader vision combines a focus on health gain with a commitment
to reducing inequalities in its social distribution. (Graham, 2004, p. 115)

Different types of national strategic approaches have been developed to address health inequalities, including legislative commitments (e.g., Greece, Germany), policy statements (e.g., Denmark, France), and quantitative targets (e.g., the United Kingdom, Ireland). With respect to suicide prevention, however, there has been a nearly universal failure to consider equality issues in the formulation of national strategies. These typically aim to reduce completed suicide (and sometimes nonfatal

1 http://www.who.int/hia/about/glos/en/index1.html (World Health Organization).

The International Handbook of Suicide Prevention, Second Edition. Edited by Rory C. O’Connor and Jane Pirkis. © 2016 John Wiley & Sons, Ltd. Published 2016 by John Wiley & Sons, Ltd.

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