News

Widening income gap will prevent health gains

Three influential reports published recently suggest that the government’s Health of the Nation programme will fail to achieve its goals unless it takes on board another key target area - poverty.

A major OPCS survey of ill-health among children acknowledges the influences on health of factors ‘outside the health area’. The research also recognises that many health professionals now believe ‘social class inequalities in adult health are at least in part caused by childhood conditions’.

A chapter on ‘The Changing Context of Childhood’ points out that:

• In 1989, 23 per cent (2.9m) of all children in the UK were living in families with no full time wage earner
• The number of children in families receiving supplementary benefit because of unemployment rose from 339,000 in 1979 to 1,087,000 in 1986
• The number of households accepted as homeless rose from 53,000 in 1978 to 145,800 in 1990. Over 80 per cent of these households (117,800 in 1990) either had dependent children or a household member who was pregnant.

And while poverty and social inequality create the conditions for many illnesses to thrive, they also play an important part in how people are able to respond.

The OPCS report notes that hospital admissions for childhood asthma have increased 13-fold since the early 1960s and that asthma is now the most important cause of emergency admission to hospital.

Research by the National Asthma Campaign indicates that asthma is more than twice as likely to hit people severely if they are poor. About 86 per cent of people disabled by asthma are in socio-economic groups 3, 4 and 5. Only about 14 per cent are in groups 1 and 2.

Asthma affects everyone ‘regardless of class’, an NAC spokesperson said. But with nebulisers (costing £100 or more) not available on prescription, the ability of many people in poorer households to control their condition is decreased - continuing the cycle of illness, unemployment and poverty.

Recent macro-economic research suggests, however, that the ‘health gap’ may get wider. A report commissioned by the Organisation of Economic Co-operation and Development shows that inequality in the UK has, in fact, been increasing faster than in any other industrialised country.

It shows that although the US continues to be the country with the sharpest divide between rich and poor, the UK is the catching up fast.

The most well-off 20 per cent of the UK population increased its share of national income from 36 per cent to 43 per cent during the 1980s, while the poorest 20 per cent experienced a fall in its share from over 9 per cent down to 7 per cent.

The Health of our Children. Decennial Supplement, is available from HMSO. £21. The Hidden Cost: A National Asthma campaign investigation into severe asthma, £10 from the National Asthma Campaign