A study of inequalities is at its best on analysis, writes Lucy Reynolds

Whatever field of public health you work in, you would do well to add Understanding Health Inequalities to your reading list. This excellent book offers historical and theoretical analysis of health inequalities, with practical illustration through well-chosen case studies and policy documents.  

The book has three main sections. Part one reviews the evidence of how health inequalities are formed and maintained. For example, it introduces the “life course” concept, where social inequalities in infancy, adulthood and older age all contribute to the socio-economic gradient in health. It also explores the relative influence of composition (individual factors such as social class) versus context (neighbourhood characteristics) over a society’s inequalities gradient.

Part two focuses on how ethnicity, religion, disability, age and gender contribute to health inequalities. It considers how these parts of an individual’s identity intersect with one another, not only influencing their sense of self, but also their potential to realise personal ambitions in the face of prejudice or discrimination.

Part three concerns the role of policy in influencing the social distribution of health determinants, such as considering how tobacco control influences inequalities in smoking and mortality.

Where this book falls short is in helping readers to understand how to translate this understanding into further action. More practical examples of how social determinants have been positively influenced through local and national policies and interventions could, therefore, only have strengthened the publication.

Lucy Reynolds is a consultant at Finnamore.

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