The government has been accused of failing to tackle health inequalities fully because it is too 'afraid' of upsetting the electorate.

Nottingham University professor of medical epidemiology Richard Wilkinson said politicians and economists were refusing to take on board research that showed progressive tax reform was the only way to improve health outcomes.

Speaking at the annual health conference of the Unite union last week, Professor Wilkinson said: 'The government has been quite mistaken in allowing top incomes to take off.

'Right at the bottom of society there have been improvements in violence and teenage pregnancy, however it's how much behind the rest they are that matters.'

'I have no doubt that it's the extremes of income that need to be dealt with. But it's difficult convincing economists that there's anything in it at all.'

He presented new findings showing that the level of income inequality in a society is the biggest factor in a number of health and social problems such as deaths from drug overdoses, obesity and teenage pregnancies.

Instead of spending money on more doctors, social workers and drug rehabilitation units, it may be cheaper and more effective to tackle underlying income inequalities, his report - The Problems of Relative Deprivation: why some countries do better than others - argues.

While health expenditure was important, there was no link to life expectancy, he said. The only way to help people to live longer was through tax reform.

He told HSJ: 'The government is afraid of the electorate. It has redistributed income but hasn't done enough.

'That's stopped income differences from getting bigger but not made them smaller.

'Most of the attempts to stop health inequalities have been to stop inequalities affecting health rather than reducing the inequality. We need to do more.'

But Julian le Grand, Tony Blair's former health adviser and social policy professor at the London School of Economics, said Professor Wilkinson was too 'pessimistic'.

'There's no doubt that health inequalities have proved extremely stubborn to eliminate. On the other hand, there are measures that one can take that don't necessarily involve a massive amount of redistribution.'

He gave examples of policies such as permits for smokers wishing to buy cigarettes and a ban on salt in processed food, which he unveiled two weeks ago as part of a new public health drive.

'We're not going to get massive redistribution so we have to work with what we've got. There are ways of inducing behaviour change that can have a positive impact on health inequalities.'

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