Health inequalities: trends, progress, and policy.

Health inequalities, which have been well documented for decades, have more recently become policy targets in developed countries. This review describes time trends in health inequalities (by sex, race/ethnicity, and socioeconomic status), commitments to reduce health inequalities, and progress made to eliminate health inequalities in the United States, United Kingdom, and other OECD countries. Time-trend data in the United States indicate a narrowing of the gap between the best- and worst-off groups in some health indicators, such as life expectancy, but a widening of the gap in others, such as diabetes prevalence. Similarly, time-trend data in the United Kingdom indicate a narrowing of the gap between the best- and worst-off groups in some indicators, such as hypertension prevalence, whereas the gap between social classes has increased for life expectancy. More research and better methods are needed to measure precisely the relationships between stated policy goals and observed trends in health inequalities.

[1]  N. Stinson,et al.  The science of eliminating health disparities: summary and analysis of the NIH summit recommendations. , 2010, American journal of public health.

[2]  Adewale Troutman,et al.  Health disparities and health equity: the issue is justice. , 2011, American journal of public health.

[3]  Stella M. Yu Healthy People 2010 , 1998, Maternal and Child Health Journal.

[4]  R. Heidel,et al.  Healthy People 2000: national health promotion and disease prevention objectives (excerpts). US Public Health Service. , 1991, Journal of allied health.

[5]  Ichiro Kawachi,et al.  Income inequality and health: what have we learned so far? , 2004, Epidemiologic reviews.

[6]  K. Stronks,et al.  UvA-DARE ( Digital Academic Repository ) A strategy for tackling health inequalities in the Netherlands , 2002 .

[7]  Danielle C. Ompad,et al.  Hidden cities: unmasking and overcoming health inequities in urban settings , 2010 .

[8]  T. Gary,et al.  Exploring Health Disparities in Integrated Communities: Overview of the EHDIC Study , 2007, Journal of Urban Health.

[9]  Stephen B. Thomas,et al.  Toward a fourth generation of disparities research to achieve health equity. , 2011, Annual review of public health.

[10]  Bennett Jc Inclusion of women in clinical trials--policies for population subgroups. , 1993 .

[11]  Philip M. Hauser,et al.  Differential Mortality in the United States: A Study in Socioeconomic Epidemiology. , 1974 .

[12]  T. Laveist,et al.  Minority Populations and Health: An Introduction to Health Disparities in the United States , 2005 .

[13]  David R Williams,et al.  Socioeconomic disparities in health in the United States: what the patterns tell us. , 2010, American journal of public health.

[14]  S. Bleich,et al.  Social context explains race disparities in obesity among women , 2010, Journal of Epidemiology & Community Health.

[15]  Sir Donald Acheson Independent inquiry into inequalities in health report , 1998 .

[16]  P. Remington,et al.  Grading and Reporting Health and Health Disparities , 2009, Preventing chronic disease.

[17]  J. Mackenbach Socioeconomic inequalities in health in the Netherlands: impact of a five year research programme , 1994, BMJ.

[18]  Meera Ramesh,et al.  Effect of special diabetes program for Indians funding on system changes in diabetes care and outcomes among American Indian/Alaska Native people 1994–2004 , 2008, International journal of circumpolar health.

[19]  G. Turrell,et al.  Health Inequalities in Australia: mortality , 2005 .

[20]  O. Carter-Pokras,et al.  What is a “Health Disparity”? , 2002, Public health reports.

[21]  Marco Mira d’Ercole,et al.  Trends and Determinants of Fertility Rates: The Role of Policies , 2005 .

[22]  C. Borrell,et al.  The study of social inequalities in health in Spain: where are we? , 1999, Journal of epidemiology and community health.

[23]  Jiaquan Xu,et al.  Deaths: final data for 2007. , 2010, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[24]  Naomi Adelson,et al.  The Embodiment of Inequity: Health Disparities in Aboriginal Canada , 2005, Canadian journal of public health = Revue canadienne de sante publique.

[25]  K. Flegal,et al.  Prevalence of overweight and obesity in the United States, 1999-2004. , 2006, JAMA.

[26]  L. Berkman,et al.  Social epidemiology: social determinants of health in the United States: are we losing ground? , 2009, Annual review of public health.

[27]  E. Regidor,et al.  Decreasing socioeconomic inequalities and increasing health inequalities in Spain: a case study. , 2006, American journal of public health.

[28]  J. Hart Inequalities in Health, The Black Report , 1983 .

[29]  A. Mokdad,et al.  REACH 2010 surveillance for health status in minority communities - United States, 2001-2002 , 2004 .

[30]  P. Braveman,et al.  Health disparities and health equity: concepts and measurement. , 2006, Annual review of public health.

[31]  Michael Marmot,et al.  Social determinants of health inequalities , 2005, The Lancet.

[32]  Johan P Mackenbach,et al.  Tackling socioeconomic inequalities in health: analysis of European experiences , 2003, The Lancet.

[33]  D. Hunter,et al.  Getting to grips with health inequalities at last? , 2010, BMJ : British Medical Journal.

[34]  N. Adler,et al.  U.S. disparities in health: descriptions, causes, and mechanisms. , 2008, Annual review of public health.

[35]  M. Marmot Tackling health inequalities 10 years on. A review of developments in tackling health inequalities in England over the last 10 years , 2009 .

[36]  Patrick Richard,et al.  The Economic Burden of Health Inequalities in the United States , 2009 .

[37]  D. Brandon,et al.  Social context as an explanation for race disparities in hypertension: findings from the Exploring Health Disparities in Integrated Communities (EHDIC) Study. , 2008, Social science & medicine.

[38]  T. Gary-Webb,et al.  Environmental and Socio-Economic Factors as Contributors to Racial Disparities in Diabetes Prevalence , 2009, Journal of General Internal Medicine.

[39]  E. Sondik,et al.  Progress toward the healthy people 2010 goals and objectives. , 2010, Annual review of public health.

[40]  B. Smedley,et al.  Unequal Treatment: Con-fronting Racial and Ethnic Disparities in Health Care , 2002 .

[41]  M. Whitehead,et al.  Tackling inequalities in health : An agenda for action , 1999 .

[42]  H. Davies,et al.  Evidence into policy and practice? Measuring the progress of U.S. and U.K. policies to tackle disparities and inequalities in U.S. and U.K. health and health care. , 2006, The Milbank quarterly.

[43]  E. Ngui,et al.  Racial and Ethnic Health Disparities in North Carolina REPORT CARD 2003 , 2003 .

[44]  I. Leck,et al.  The Black report , 1990, BMJ.

[45]  J. Martin,et al.  Births: preliminary data for 2005. , 2006, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[46]  David R. Williams,et al.  Measuring social class in US public health research: concepts, methodologies, and guidelines. , 1997, Annual review of public health.

[47]  David R. Williams,et al.  Racial Residential Segregation: A Fundamental Cause of Racial Disparities in Health , 2001, Public health reports.

[48]  V. Navarro,et al.  Race or class versus race and class: mortality differentials in the United States , 1990, The Lancet.

[49]  M G Marmot,et al.  Employment grade and coronary heart disease in British civil servants. , 1978, Journal of epidemiology and community health.

[50]  I. Kawachi,et al.  Income inequality, mortality, and self rated health: meta-analysis of multilevel studies , 2009, BMJ : British Medical Journal.

[51]  T. Oliver Population Health Rankings as Policy Indicators and Performance Measures , 2010, Preventing chronic disease.

[52]  Trends in Prevalence, Awareness, Treatment, and Control of Hypertension in the United States, 1988-2000 , 2003 .

[53]  N. López,et al.  Social inequities of health in Spain. Report of the Scientific Commission for the Study of Social Inequities in Health in Spain , 1996 .

[54]  M. D. Looper,et al.  Health inequalities in Australia: morbidity, health behaviours, risk factors and health service use , 2006 .

[55]  V. Navarro The "Black Report" of Spain--the Commission on Social Inequalities in Health. , 1997, American journal of public health.

[56]  Michael Marmot,et al.  Fair society, healthy lives : the Marmot Review : strategic review of health inequalities in England post-2010. , 2010 .

[57]  C. Hogstedt,et al.  The Swedish public health policy and the National Institute of Public Health. , 2004, Scandinavian journal of public health. Supplement.

[58]  F Vinicor,et al.  The continuing epidemics of obesity and diabetes in the United States. , 2001, JAMA.

[59]  T. Laveist Racial segregation and longevity among African Americans: an individual-level analysis. , 2003, Health services research.

[60]  P. Howden-Chapman,et al.  International Journal for Equity in Health Open Access Tackling Health Inequalities: Moving Theory to Action , 2022 .

[61]  J. Bongaarts The End of the Fertility Transition in the Developed World , 2002 .

[62]  S. Friel,et al.  Action on the social determinants of health and health inequities goes global. , 2011, Annual review of public health.

[63]  Margaret Whitehead,et al.  The Concepts and Principles of Equity and Health , 1992 .

[64]  P. Braveman,et al.  Defining equity in health , 2003, Journal of epidemiology and community health.