European University Institute Library

Health inequalities, persistence and change in European welfare states, Johan P. Mackenbach

eng

Includes bibliographical references and index

illustrations

index present

non fiction

Health inequalities

bibliography

1104048747

Johan P. Mackenbach

persistence and change in European welfare states

People in a better socioeconomic position do not only lead more comfortable lives, but also longer and healthier lives. This is true not only in the poorer parts of the world but also in the richest countries, including the advanced welfare states of Western Europe which have successfully pushed back poverty and other forms of material disadvantage. Why are health inequalities - systematically higher rates of disease, disability, and premature death among people with a lower level of education, occupation or income - so persistent? How can we expect to reduce this when it persists even in the most advanced states? Written by a leading figure in public health, this book looks to answer these questions by taking a broad, critical look at the scientific evidence surrounding the explanation of health inequalities, including recent findings from the fields of epidemiology, sociology, psychology, economics, and genetics. It concludes that a simplistic view, in which health inequalities are a direct consequence of social inequality, does not tell us the full story. Drawing upon a unique series of studies covering 30 European countries and more than three decades of observations, it shows that health inequalities are partly driven by autonomous forces that are difficult to counteract, such as educational expansion, increased social mobility, and rapid but differential health improvements. Finally, the book explores how we might use these new findings to continue our efforts to build a healthier and more equal future. Offering a truly multidisciplinary perspective and an accessible writing style, Health Inequalities is an indispensable resource for health researchers, professionals, and policy-makers, as well as for social scientists interested in inequality. --, Provided by publisher

Chapter 1. Introduction. More illness within shorter lives. The great paradox of public health. The need for a broader picture. Preview: this book's main conclusions Chapter 2. Patterns of health inequalities. Measurement issues. Generalized, but uneven. Persistent, but dynamic. Ubiquitous, but variable. Health inequalities outside Europe. Chapter 3. Explanatory perspectives. Methodological issues. Education, occupation, income and health. Six groups of contributing factors. Theories about the explanation of health inequalities. Chapter 4. Patterns of health inequalities explained. Set-up of the analyses. Changes in social stratification Rapid but differential health improvements. Differential effects of factors driving population health change. Continued social patterning of health determinants. Understanding the European experience. Chapter 5. A broader picture. Why social inequality persists in modern welfare states. Health inequalities and welfare state reform. Health inequalities and social justice. Chapter 6. Policy implications. Proposals for tackling health inequalities. National attempts at tackling health inequalities. Realistic expectations. Final reflections