On aggregate

While the proportion of the English population engaging in 3 or 4 key "unhealthy behaviours" (smoking, alcohol consumption, poor diet, limited physical activity) has decreased in recent years (down from 33% in 2003 to 25% in 2008), the focus of this improvement is amongst richer, better educated people.  Those with no educational qualifications are far more likely to engage in all four behaviours and this tendency has increased over time, with the result that the poorest and least well educated have seen no improvement and relative inequalities have increased.  The King's Fund takes data from the Health Survey for England between 2003 and 2008 to examine how health behaviours cluster, arguing that focus on individual health behaviours, while helpful, is not the solution: a more holistic approach is necessary.

Measure up

A review published in the BMJ takes a look at the measures used in reporting health inequalities.  It finds that most studies use relative measures of effect rather than absolute, which, as the study's authors point out "may influence readers’ judgments of the magnitude, direction, significance, and implications of reported health inequalities."  It should be noted that the review is a bit of a straw poll, as it only covered one year's worth of research in 10 leading medical, pulic health and epidemiology journals.

Could do better

A major review for the WHO published in the Lancet maps health inequalities in the 53 states of the WHO European region.  Commissioned to support development of the WHO's new health policy framework for Europe, Health 2020, the review highlights substantial variations between and within states.  Lead author, Professor Sir Michael Marmot stressed the importance of attending to the issue:  "health inequality needs to be one of the main criteria by which we assess the effectiveness of countries’ health systems, and the effectiveness of government as a whole."