The economics of health inequality in the English NHS – the long view

The Centre for Health Economics in York has published the following report ‘The economics of health inequality in the English NHS– the long view’.

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This paper outlines some of the key milestones of health inequality policy in England, and how socioeconomic inequalities in health, government policy towards it, and the academic literature about it, have evolved over time and in relation to each other. Whilst this historical review is far from comprehensive, its aim is to provide sufficient context within which to interpret current NHS health inequality policy from the perspective of an economist.

Reflecting back over the last 200 years or so of health policy in England we see that great progress has been made in improving the health of the population overall – though when we look more closely we find that at each key historic juncture in health policy these improvements have come at the expense of increasing socioeconomic inequalities in health.

Policy makers, particularly those who have a true commitment to reducing socioeconomic inequalities in avoidable sickness and premature death, would do well to draw lessons from this history and explicitly consider the impact of their policy proposals on health inequality rather than assume that promises of improvements in the health of the mythical average citizen will solve the problem of health inequality. In fact, history would suggest that unless carefully designed with the explicit goal of reducing health inequality in mind, such ‘cost-effective’ policies will only act to exacerbate this health divide.

Read the report here


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