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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 July 7; 335(7609): 8.
PMCID: PMC1910662
Tackling Health Inequality

What are the causes?

James N Hardy, principal general practitioner

Heath demands that we “get tough on the causes of health inequality.”1 She seems to imply that it's a rich-poor thing, a widening of the gap between haves and have-nots.

But why exactly is the United Kingdom 21st out of the 27 European Union countries? Is it because we stand side by side with the United States and are increasingly embracing privatised health? Is it because we have an archaic feudal society? Is it because our expansionist past is finally catching up with us? Well, I don't know, and my guess is that none of us does and so if we choose, as Heath suggests we should, to “pursue political answers alongside technical ones” we are reduced at best to nibbling around the edges of something that is so large that it has neither form nor shape.

Real change requires inspirational leadership that is strong and sustained. It will also require the debunking of some of our great institutions, not least, the monarchy, which stands at the helm of our divided society.


Competing interests: None declared.


1. Heath I. Let's get tough on the causes of health inequality. BMJ 2007;334:1301 (23 June.) [PMC free article] [PubMed]

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