Health inequalities blight our communities. It is unacceptable that in the first decade of the 21st century, the length of a person's life is still determined by where they were born and their social status.

These inequalities exist everywhere, not just in the most disadvantaged groups and areas. This requires a national response, one that addresses health inequalities across the country and that narrows the gap between them and the rest of the country.

We have made health inequalities a priority for action by adopting a target for 2010 and a national strategy. Health Inequalities: progress and next steps takes stock of developments and reiterates our commitment to tackling this problem. We looked again at the lives people lead, the influences on their health and the services they use, as a way of identifying additional areas for action. This will help us meet the 2010 target.

Reaching out

We are also looking beyond the target. We need to reach out to all primary care trusts and local authority areas - while maintaining a focus on the most disadvantaged groups and areas - if we are to achieve a long-term and sustainable reduction in health inequalities. We also need to ensure that action improves the quality of life as well as its length and that it lessens the health inequalities gradient between different groups in all communities.

This government's record investment in the NHS has been an important factor in improving the health and well-being of everyone. Life expectancy among disadvantaged groups is now the same - or better - than that for the whole of the population eight years ago. Infant mortality is at a historic low, including for routine and manual groups.

Equally, much has been done to tackle the economic and social conditions in which health inequalities flourish. This includes the health and educational needs in the early years of life, which have been addressed through Sure Start children's centres, universal nursery provision, child poverty and through improving housing quality for vulnerable households.

Variations in health

The health gap persists, in spite of these improvements and the narrowing of the gap in relation to heart disease and cancer. We must redouble our efforts. In the health service, this means mainstreaming health inequalities by integrating them into NHS commissioning and the operational framework.

Local government is our key partner in providing a wider social dimension to meeting this challenge. Local authorities have often led these efforts, and increasingly local government, the NHS and the third sector are working in partnership to deliver change. Together, these organisations have started the difficult job of raising the expectations of local communities about their health and well-being in the most disadvantaged areas.

Over the last few years, we have developed and strengthened the tools and levers needed to meet this challenge and aligned our processes and incentives to support local joint action and collaboration.

Making a difference

Evidence is also important in guiding our efforts and it is improving. This supplement describes what is happening in the NHS and local government and how current work and plans are making a difference to people - as patients and citizens - and to the way we work and deliver services both on the front line and in the backroom.

We all have a part to play in addressing and ultimately narrowing the health inequalities gap. We are already facing up to this challenge of breaking the links between lack of wealth and poor health and of giving everyone the chance to contribute fully to society.

I am determined to reinforce our efforts in this area.

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