By Nick J. Spencer, Elizabeth Dowler
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Extra resources for Challenging health inequalities : from Acheson to 'choosing health'
This chapter1 seeks to explore how government policy has developed on health inequalities and how the Acheson Report and its recommendations have contributed to its development. Background Tessa Jowell, the new Minister for Public Health, appointed to attack the root causes of ill health (Labour Party, 1997), wrote to Sir Donald Acheson, a former Chief Medical Officer for England, on 10 July. She invited him to undertake a review of health inequalities that would contribute to a new strategy for health.
It brought together many of the principles that shaped Acheson – and was the fullest official expression of them. This included: • • • asserting the role of the wider determinants of health – ‘upstream’ and well as ‘downstream’ factors – with its corollary of action across all levels of government; framing action in terms that reflected the social gradient of health rather than focusing on socially excluded groups; and, underlining the importance of action over the long term if policies were to achieve results.
The Status report on the Programme for Action, published in August 2005 (DH, 2005b), 27 Challenging health inequalities provided a first review of data against the 2010 PSA target, the 12 national headline indicators and the set of departmental commitments included in the strategy. Covering developments up to 2003, it showed no narrowing of health inequalities against the PSA target. There was a continuing widening of these inequalities as measured by infant mortality and life expectancy reflecting the long-term trend; however, there were: … signs that some of the indicators associated with health inequalities are moving in the right direction.