Health inequalities: key references and evidence

***Note: This is not, and is not intended to be, a comprehensive list of references relevant to health inequalities. More detailed lists are available from some of the publications cited below.***

The causes of health inequalities

Main message/finding: transition to a capitalist economy and neoliberal restructuring tends to increase inequalities. A functioning welfare state tends to decrease inequalities.

• Beckfield J, Krieger N. Epi + demos + cracy: linking political systems and priorities to the magnitude of health inequities - evidence, gaps, and a research agenda. Epidemiologic Reviews 2009; 31: 152-77.

Main message/finding: there is a strong link between income inequality and health inequality.

• Dorling D., Mitchell R., and Pearce J. The global impact of income inequality on health by age: an observational study. BMJ 2007;335(7625):873.

Reducing health inequalities

Main message/finding: This report described inequalities in Europe, the main risk factors and the main levers to reduce inequalities across Europe.

• Eikemo T.A. & Mackenbach J.P. (Eds).  EURO GBD SE: the potential for reduction of health inequalities in Europe. Final Report. University Medical Center Rotterdam, 2012

Main message/finding: reducing health inequalities requires policies that are ambitious sustained and systematic.  

• EUROTHINE project. Tackling health inequalities in Europe: an integrated approach (final report). Rotterdam, 2007.

Main message/finding: provides a comprehensive set of recommendations for reducing health inequalities.

• WHO Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. World Health Organization, 2008.

Main message/finding: describes the concepts and principles on which actions for tackling health inequities should be based.

• Whitehead M., Dahlgren G. Concepts and principles : Levelling Up Parts 1 & Part 2. World Health Organisation 2006.

Policy impact

Main message finding: Equally well mainly focused on focused on mitigating the consequences of inequalities rather than addressing the underlying causes, such as income and poverty.

• Beeston C., McCartney G., Ford J., Wimbush E., Beck S., MacDonald W., Fraser A. Health Inequalities Policy review for the Scottish Ministerial Task Force on Health Inequalities. Glasgow: NHS Health Scotland; 2013.

Main message finding: this report assess how well public sector organisations are working together to tackle health inequalities.

• Audit Scotland. Health Inequalities in Scotland 2012.

Health inequalities: trends and inequalities

Scotland/UK

2024:

• 2024 Inequality Landscape Scottish Health Equity Research Unit. 2024 Catalano, Congreve, Jack.

2023:

• Health Foundation: Leave no one behind The state of health and health inequalities in Scotland, 2023.

2022:

• Health Inequalities in Scotland: Trends in deaths, health and wellbeing, health behaviours, and health services since 2000 (MRC SPHSU) 2022
• Fraser of Allander Institute (2022). Health Inequalities in Scotland: Trends in the socio-economic determinants of health in Scotland.
• Diffley Partnership, 2022. Health Inequalities in Scotland: Public Engagement Research
• Report from Health, Social Care and Sport parliamentary Committee inquiry into Health Inequalities: Tackling Health Inequalities in Scotland

2020:

• Marmot M., Allen J., Boyce T., Goldblatt P., Morrison J. Health equity in England: The Marmot Review 10 years on. London: Institute of Health Equity; 2020
• Marmot M., Allen J., Goldblatt P., Herd E., Morrison J. Build Back Fairer: The COVID-19 Marmot Review. The Pandemic, Socioeconomic and Health Inequalities in England. London: Institute of Health Equity; 2020

2019:

• Brown D., Allik M., Dundas R., Leyland A.H. All-cause and cause-specific mortality in Scotland 1981-2011 by age, sex and deprivation: a population-based study. European Journal of Public Health 2019; 29(4): 647-655.

2010:

• Marmot M., Allen J., Goldblatt P., Boyce T., McNeish D., Grady M., Geddes I. The Marmot Review: Fair Society, Healthy Lives. Strategic review of health inequalities in England post-2010. London: Institute of Health Equity; 2010

2007:

• Dorling D., Rigby J., Wheeler B., Ballas D., Thomas B., Fahmy E., Gordon D. and Lupton R. Poverty and wealth across Britain 1968 to 2005. Joseph Rowntree Foundation, The Policy Press, 2007

2002:

• Davey Smith G., Dorling, D., Mitchell, R., and Shaw M. Health inequalities in Britain: continuing increases up to the end of the 20th century. Journal of Epidemiology and Community Health 2002; 56: 434-435.

1998:

• Acheson D. Independent inquiry into inequalities in health: report. HMSO; 1998.

1980s:

• (Also known as the “Black report”). Black D., Morris J., Smith C., Townsend P. Inequalities in health: report of a Research Working Group. London: Department of Health and Social Security, 1980.
• Whitehead M. The Health Divide. London: Health Education Council; 1987.

Elsewhere:

• Krieger N., Rehkopf D.H., Chen J.T., Waterman P.D., Marcelli E., Kennedy M. The Fall and Rise of US Inequities in Premature Mortality: 1960–2002. PloS Medicine 2008; 5(2): 227-241
• Kunst A.E. et al. Monitoring of trends in socioeconomic inequalities in mortality: experiences from a European project. Demographic Research, April 2004.
• Mackenbach, J.P., Stirbu I., Roskam A.R., Schaap M.M., Menvielle G., Leinsalu M., and Anton E. Kunst. Socioeconomic Inequalities in Health in 22 European Countries. N Engl J Med 2008;358:2468-81.

Fundamental causes

• Link B.G, Phelan J.C. McKeown and the Idea That Social Conditions Are Fundamental Causes of Disease. American Journal of Public Health 2002; 92(5).
• Scott S, Curnock E, Mitchell R, Robinson M, Taulbut M, Tod E, McCartney G. What would it take to eradicate health inequalities? Testing the fundamental causes theory of health inequalities in Scotland. NHS Health Scotland, Glasgow, 2013. 

Tools for local authorities

• Health Development Agency. Promoting Healthier Communities and narrowing health inequalities: a self-assessment tool for local authorities. HDA, 2004.

Understanding health inequalities

• Kawachi I., Subramanian S.V., Almeida-Filho N. A glossary for health inequalities. Journal of Epidemiology & Community Health 2002; 56: 647–652.
• McCartney G, Collins C, Mackenzie M. What (or who) causes health inequalities: theories, evidence and implications? Health Policy 2013;113(3):221-227
• Navarro V. What we mean by social determinants of health. International Journal of Health Services 2009; 39(3): 423–441

How to measure health inequalities

• OECD How's Life? 2024 Well-being and Resilience in Times of Crisis How's Life? 2024 | OECD
• Carr-Hill R., Chalmers-Dixon P. Public Health Observatory Handbook of Health Inequalities Measurement. South East Public Health Observatory (SEPHO), 2005
• Regidor E. Measures of health inequalities: part 1. J.Epidemiol.Community Health 2004;58:858-61.
• Regidor E. Measures of health inequalities: part 2. J.Epidemiol.Community Health 2004;58:900-3.

Books

• Dorling D. Injustice: why social inequality persists. Bristol: The Policy Press; 2010.
• Graham H. The challenge of health inequalities. In: Graham H. (Editor). Understanding health inequalities. Maidenhead: Open University Press; 2009
• Shaw, M., Dorling, D., Gordon, D., & Davey Smith, G. The Widening Gap: health inequalities and policy in Britain, 2nd edition. Bristol: The Policy Press; 1999.
• Wilkinson R, Pickett K. The Spirit Level: Why More Equal Societies Almost Always Do Better. London: Penguin; 2009

Miscellaneous

• Walsh D., Lowther M., McCartney G., Reid K. Can Scotland achieve its aim of narrowing health inequalities in a post-pandemic world? Public Health in Practice 2020; 1: 100042

Effectiveness evidence

ScotPHO's purpose is to describe the pattern of health across the Scottish population. As a supplementary service to users, we include the following links to external sources of quality-assured evidence on effectiveness of interventions which may include relevant material for this topic. These links are provided as an aid to users. They are by no means exhaustive nor should they be necessarily viewed as authoritative.

Centre for Reviews and Dissemination

Cochrane Library: Browse by topic

EPPI-Centre: Evidence library

National Institute for Health and Care Excellence (NICE) Guidance: Find guidance

Scottish Intercollegiate Guidelines Network (SIGN)