Letter

Why disadvantage causes disease

Dear healthmatters—It is good to see Gordon Brown’s extra support for children living in poorest households and communities. For the goal of eliminating childhood poverty will require substantial and sustained shifts in Government policy and funding; and this goal is essential if today’s disadvantaged children are going to grow up into tomorrow’s healthy people.

Health is affected by where we live, in this country and across the world: the advantages rich children gain from growing up in rich areas contrast with the disadvantages poor children experience from living in poor areas.

It is affected across time: educational attainment is related to health through the benefit it gives people in their later socio-economic directions, not simply because education encourages healthy behaviours.

If anyone doubts the causal link between poverty and ill health, we should ask, when children in households with no employed adults rose from 4 per cent of all households in 1981 to 10 per cent in 1991, why it was that in areas of worst health, the increase was from 8 per cent to 25 per cent?

And if anyone thinks that being ill in childhood makes people poor, we should ask why were the poor more likely to be ill when they were young?

Health inequalities follow the clustering of disadvantage – in opportunity, material circumstances and behaviours related to health – starting in childhood and continuing across people’s lifetimes. The resulting polarisation of life chances mean that, to give all our children the best future possible, we must be tough on inequalities and tough on the causes of inequalities.