Review

Equal to the task

UNDERSTANDING HEALTH INEQUALITIES
Hilary Graham (ed)
Open University Press, 2000, £17.99

Reducing inequalities in health is central to the government’s agenda, and the index of contributors to this collection reads like a Who’s Who of leading researchers in the field of economic and social research.

This book is an important, timely publication that will undoubtedly become essential reading for students and all those interested in exploring sources of inequalities, particularly among women and minority ethnic populations.

At times, I questioned whether my understanding of health inequalities was actually being improved or confused by the subtle and complex ways of capturing new sources of inequalities. This was especially the case where the emphasis was construed socially, the standard by which it was measured and what the particular health impact was, were less than obvious.

The inadequacy of socio-economic classifications based on occupations was acknowledged in the introduction, but I think the book would have been better balanced had it included a chapter on the collapse of heavy manufacturing industries, the erosion of occupations classified as skilled manual, and the consequent impact on the status and health of men and couple households in the UK. The absence of such material resulted in a selective and partial view of inequalities in health.

I also found myself fidgeting and wondering when the book would move on from description to examining the health impact of policy? This didn’t happen explicitly until I reached the last of the four sections, which contained a solitary essay.

But it was worth waiting for. Margaret Whitehead and colleagues confronted the methodological challenges that will have to be faced in examining policy and health, head-on.

The cross-country comparative study of the health of lone and couple parents in Sweden and the UK stood out like a beacon in the middle of what sometimes resembled a maze that led down a series of interesting paths, but might easily have caused me to lose direction.