The Black Report and Inequalities in Health

Introduction

Socio-economic class has been linked to health inequalities for many years. Edwin Chadwick published his ‘General Report on the Sanitary conditions of the Labouring Population of Great Britain’ in 1842. This showed that the average age at death in Liverpool at that time was 35 for gentry and professionals but only 15 for labourers mechanics and servants. Although life expectancy has improved for all classes in Britain since this time, inequalities have remained.

The Black Report, published in 1980, showed that there had continued to be an improvement in health across all the classes (during the first 35 years of the National Health Service) but there was still a co-relation between social class, (as measured by the old Registrar General’s scale) and infant mortality rates, life expectancy and inequalities in the use of medical services.

The National Statistics Socio-Economic Classification (NS-SEC) has been introduced since then. Chandola and Jenkinson have it together with the Short Form health survey (SF-36), (a measure of health outcomes), to show that correlations between social class and health inequalities continue to be significant.