Health inequalities – such as the greater burden of illness and premature death faced by poor people compared to their wealthier neighbours – are critically important issues for governments to tackle, according to a powerful new report from the UK House of Commons Health Committee, published yesterday. Research from the Wellesley Institute, including Poverty Is Making Us Sick, Sick and Tired and the Street Health Report, confirms that the gap in health among different groups is widespread in Canada. The UK Commons Committee warns that tossing loads of money won’t necessarily close the terrible gaps in health and offers some practical policy advice. Here are some excerpts:
“Health inequalities are not only apparent between people of different socio-economic groups—they exist between different genders, different ethnic groups, and the elderly and people suffering from mental health problems or learning disabilities also have worse health than the rest of the population. The causes of health inequalities are complex, and include lifestyle factors—smoking, nutrition, exercise to name only a few—and also wider determinants such as poverty, housing and education. Access to healthcare may play a role, and there are particular concerns about ‘institutional ageism’, but this appears to be less significant than other determinants.”
“One of the major difficulties which has beset this inquiry, and indeed is holding back all those involved in trying to tackle health inequalities, is that it is nearly impossible to know what to do given the scarcity of good evidence and good evaluation of current policy.”
“Policy cannot be evidence-based if there is no evidence and evidence cannot be obtained without proper evaluation. The most damning criticisms of Government policies we have heard in this inquiry have not been of the policies themselves, but rather of the Government’s approach to designing and introducing new policies which make meaningful evaluation impossible. Even where evaluation is carried out, it is usually “soft”, amounting to little more than examining processes and asking those involved what they thought about them.”
“All too often Governments rush in with insufficient thought, do not collect adequate data at the beginning about the health of the population which will be affected by the policies, do not have clear objectives, make numerous changes to the policies and its objectives and do not maintain the policy long enough to know whether it has worked. As a result, in the words of one witness, ‘we have wasted huge opportunities to learn’.”