Health inequalities

Abstract ‘Health inequalities—persistence and change in European welfare states’ studies why frequencies of disease, disability, and premature mortality are higher among people with a lower socioeconomic position, even in countries with advanced welfare states. Drawing upon data from 30 countries covering more than three decades, it provides a comprehensive overview of trends and patterns of health inequalities, showing that these are not only ubiquitous and persistent, but also highly variable and dynamic. It provides a critical assessment of recent research into the explanation of health inequalities, discussing methodological pitfalls, summarizing findings from epidemiological, sociological, economic, and genetic studies, and reviewing nine overarching theories. Based on in-depth studies of the determinants of health inequalities in European countries, it shows that the persistence of health inequalities is due to a combination of mostly favourable changes in social stratification, massive but differential health improvements, and persistence of social inequality in material and non-material living conditions. It discusses why social inequality is so persistent, and whether welfare state reform could contribute to reducing health inequalities, and provides a systematic analysis of the inequitableness of health inequalities according to five theories of justice. It reviews recent attempts by European national governments to reduce health inequalities, showing that it is realistic to expect evidence-based policies to reduce absolute but not relative inequalities in health. This title is written for scientists and advanced students from various disciplines, as well as for public health professionals and policymakers, and is profusely illustrated and referenced.