Promoting health against inequality: using research to identify targets for intervention — a case study of women and smoking

Abstract

With inequality back on the agenda of health promotion in the UK, researchers are being called upon to unravel the chain of risks which runs between socio economic disadvantage and poor health and to identify links in the chain where interventions should be targeted. This article is one response to the call. It is written as a contribution to a wider debate between the research and policy communities about how to understand and how to tackle health inequalities. It addresses one area of the debate, examining, and drawing policy messages from, the socio-economic patterning of women's smoking. Firstly, it describes the socio-economic differentials in women's smoking status, setting these in the context of widening income inequalities and the emergence of new forms of poverty. It notes how female smokers are concentrated among those who have lost out in the process of social polarisation. Secondly, the paper describes how women's smoking careers take shape within the socio-economic pathways which they follow through adolescence and across adulthood. Thirdly, the paper identifies a policy framework for health promotion which targets income inequalities, breaks into disadvantaged pathways and provides respite for those unable to escape their disadvantaged circumstances.