Health inequalities and New Labour: how the promises compare with real progress

Introduction

This year marks the 20th anniversary of the World Health Organization's Global Strategy for Health for All by the Year 2000, which proposed 38 targets to reduce inequalities in health.1 These targets were taken up by the governments of many countries, including Margaret Thatcher's Conservative government in the United Kingdom, which, just like Tony Blair's current administration, wished that inequalities in health would fall (see box).

In Britain the observation of and preoccupation with health inequalities has a much longer history than the last two administrations,3 and many recent studies have documented a social and spatial polarisation of life chances continuing into the 1980s and late 1990s from a possible lull in the 1970s.4^–7 Clearly then, the Health for All aim of reducing inequalities between groups of the population had not been reached by the end of the 1990s—in fact, the opposite had occurred even though the fourth goal of increasing life expectancy has been attained.

Increasing health inequalities have been shown to reflect trends in income inequality, which also increased substantially over the last decades of the 20th century.4 8 While in opposition, the Labour party had made political capital out of the non-implementation of the recommendations of Black report.4 9 10 The New Labour government that came to power in 1997 did not initially shy away from acknowledging the wider (social and even structural) determinants of health (although the …