A sociological and historical perspective on health inequalities: implications for current policy debates Mike Kelly, Institute of Public Health and Simon Szreter, Faculty of History
Duration: 18 mins 27 secs
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Professor Kelly is Senior Visiting Fellow in the Department of Public Health and Primary Care at the Institute of Public Health at the University of Cambridge and a member of St John’s College, Cambridge. Between 2005 and 2014 he was the Director of the Centre for Public Health at the National Institute of Health and Care Excellence (NICE) where he led the teams producing public health guidelines. Professor Kelly’s research interests include the methods and philosophy of evidence based medicine, prevention of CVD, health inequalities, health related behaviour change, the causes of non-communicable disease, end of life care, dental public health and the sociology of chronic illness.
Professor Simon Szreter is a Fellow of St John's College and Professor of History and Public Policy at the Faculty of History. Professor Szreter is an historian of population, public health and reproduction. His most recent books have all presented historical studies with diverse contemporary public policy implications: Registration and Recognition. Documenting the Person in World History (2012), The Big Society Debate. A New Agenda for Social Welfare? (2011), History, Historians and Development Policy (2011) and Sex Before the Sexual Revolution (2010). Simon Szreter is a Steering Committee member of the Public Policy SRI. |
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| Created: | 2016-06-17 16:19 |
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Understanding Inequalities: new thinking for public policy
Understanding Inequalities: new thinking for public policy |
| Publisher: | University of Cambridge |
| Copyright: | Graham Copekoga |
| Language: | eng (English) |
| Abstract: | Professors Kelly and Szreters’ talk today presents a sociological and historical perspective on health inequalities and its implications for policy debates.
Epidemiological and public health accounts of health inequalities share three characteristics: they are based on individual measures of health and illness (however measured) aggregated up to population or group level; they use gross measures of social difference such as socio economic status, income or education to differentiate social groups; and, they rely for the most part on cross sectional data to depict differences or gradients in the population. While this approach has been very important in raising the political profile of health inequalities it has not provided much by way of sharp edged tools with which to change the stubborn pattern of health inequalities observed in all societies. In the UK this is despite much effort to tackle health inequalities and even more political rhetoric about dealing with the problem. We present a sociological-historical account using data from a variety of sources from the last two hundred years to illustrate the ways in which non-reductionist accounts of the relations and intersections between social groups - classes, genders and ethnicities – drives the evolving class structure nationally and locally which in turn shapes the patterning of health differences and the health inequalities gradients in societies. We emphasise the importance of the analyses being conducted at relatively local levels and across time in order to grasp the significance of the micro structures and to illustrate the role of local industries for example, in generating particular patterns of health differences. We suggest that the approach we advocate allows not only for new conceptions of health inequities to emerge to inform the policy debate, but also it points to significant places were interventions may be deployed. So for example policies about the location or closure of industries, of technical education, of labour mobility are critical in the patterning of health inequalities. These policy possibilities are along way distant from the preoccupations of for example Public Health England and its exhortations, especially to the poor and disadvantaged to Change4life and to stop smoking, eat less fat salt and sugar and take more exercise! |
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