Explanation and Social Policy: ‘The’ Problem of Social Inequalities in Health *

Abstract

Interest in the socio-economic and environmental causes of inequalities in life expectancy and health within British society has a long history. Poverty was coming to be seen as in some way associated with a particular susceptibility to disease, as well as an all too frequent consequence of chronic sickness. It is pertinent to the traditional focus of the field, and a common matter of inquiry, that social problems rarely impact equally upon all segments of society. Social class, so clearly associated with mortality and at least chronic sickness and disability, is also highly correlated with bad housing and with unemployment, as well as with low income and with certain aspects of diet. Inequalities in utilization of the health services – notably the preventive health services – play a double role both as one cause of inequalities in health, and as a problem in themselves which requires explanation.