
Contents
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Introduction to socioeconomic inequalities in health in high-income countries Introduction to socioeconomic inequalities in health in high-income countries
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The facts: description The facts: description
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Mortality Mortality
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Total mortality Total mortality
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Cause-specific mortality Cause-specific mortality
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Trends Trends
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Life expectancy is shorter in lower socioeconomic groups Life expectancy is shorter in lower socioeconomic groups
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Morbidity Morbidity
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Inequalities in generic health indicators Inequalities in generic health indicators
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Inequalities in diseases and disabilities Inequalities in diseases and disabilities
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‘Healthy life expectancy’ is shorter in lower socioeconomic groups ‘Healthy life expectancy’ is shorter in lower socioeconomic groups
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The facts: explanation The facts: explanation
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‘Selection’ versus ‘causation’ ‘Selection’ versus ‘causation’
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Early debates Early debates
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Disentangling causal effects Disentangling causal effects
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Specific causal pathways Specific causal pathways
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Material factors Material factors
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Psychosocial factors Psychosocial factors
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Health-related behaviours Health-related behaviours
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Healthcare Healthcare
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A role for genes? A role for genes?
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Overarching ideas Overarching ideas
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Life course perspective Life course perspective
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Fundamental causes Fundamental causes
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Health inequalities and the welfare state Health inequalities and the welfare state
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The options: how to build a strategy to reduce inequalities in health? The options: how to build a strategy to reduce inequalities in health?
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Normative assessment of health inequalities Normative assessment of health inequalities
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Policy development vis-à-vis health inequalities Policy development vis-à-vis health inequalities
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Approaches to reduce health inequalities Approaches to reduce health inequalities
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Comprehensive strategies: evidence from the English strategy Comprehensive strategies: evidence from the English strategy
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Conclusion Conclusion
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References References
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2.4 Socioeconomic inequalities in health in high-income countries: The facts and the options
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Published:November 2021
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Abstract
Socioeconomic inequalities in health have been studied extensively in the past decades. In all high-income countries with available data, mortality and morbidity rates are higher among those in less advantaged socioeconomic positions, and as a result differences in health expectancy between socioeconomic groups typically amount to 10 years or more. Good progress has been made in unravelling the determinants of health inequalities, and a number of specific determinants (particularly material, psychosocial, and lifestyle factors) have been identified which contribute to explaining health inequalities in many high-income countries. Although further research is necessary, our understanding of what causes health inequalities has progressed to a stage where rational approaches to reduce health inequalities are becoming feasible. Evidence of a reduction of health inequalities via interventions and policies based on the underlying causes remains scarce, and point to a need to increase efforts.
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