Evading the Issue of Widening Inequalities of Health in Britain: A Reply to Rudolf Klein

Abstract

The Black Report of 1980 prompted much discussion in Britain of the evidence about widening inequalities in health and the explanation of these inequalities. Most scientific observers supported the broad analysis, while qualifying and extending its themes and filling some of the most important gaps. However, there have been critics who have threatened to distract attention from the implications of the evidence for scientific knowledge of the causes of ill health and premature death, and therefore from policies to improve health. In a previous article in this Journal, I sought to refute one of the critics of the Black Report, Professor Rudolf Klein, by calling attention to new evidence supporting its thesis. In his response he fails to address that evidence: it continues to accumulate, and it has international reverberations. This rebuttal also lists some of the latest work.