Poor Health: Social Inequality before and after the Black Report (British Politics and Society)

The 1980 Black Report by Sir Douglas Black has kept health inequalities at the forefront of the public health agenda. This volume explores the history and development of studies and concern over health inequalities especially in relation to the 1980 report.In the 1980s the issue of inequalities and health was largely off the political agenda for the Conservative government. This lack of political attention was still apparent in the early 1990s. When the government White Paper on The Health of the Nation was published in 1992, its target-setting for health was welcomed but also criticised for avoiding contentious issues such as unemployment and health. These were perhaps less amenable to targets. Inequalities started to make a gradual reappearance in policy-making circles in the 1990s, initially using different terminology. The phrase 'variations in health' was a softer and less challenging way of reintroducing the topic. It was unclear who might carry this tentative resurgence forward as a campaigning issue. Bartley argued, in her study of unemployment and health, that public health doctors, who had displayed an earlier interest in the issue, had dropped it after their incorporation in the reformed health service machinery after 1974. 1 The election of a Labour government in 1997 saw inequalities come fully 'out of the closet'. The Acheson enquiry into inequalities in 1998 and the subsequent White Paper, together with the establishment of a 'social exclusion unit' (another redefined term) in Whitehall, saw inequalities back on the policy agenda. This volume is to some extent the product of the revived interest in inequalities.

Health inequalities have re-emerged as a major issue in the 21st century. Yet the past history of this subject has been little understood. What causes health inequalities? How can they be tackled?
This work explores how health inequalities have been examined in the past, and the policy record in treating them. The focus is on how health inequality has been dealt with since the founding of the National Health Service in 1948. Despite the egalitarian aspirations of its founders, the NHS seems to have had little effect on levels of health inequality.
One key effort to understand why was the 1980 Black Report. This was probably the most extensive effort to address the problem in post-war Britain. Yet what has been its legacy? Was it, as alleged at the time, suppressed by the Thatcher government? And what can current policymakers learn from its findings?
The contributors to this volume, both those involved in the development and objectives of health policy in Britain and academic