Has the English strategy to reduce health inequalities failed?

England, and the United Kingdom as a whole, have a long and frustrating history of engagement with socioeconomic inequalities in health. England and Wales started systematic data collection on social class inequalities in mortality e originally based on the Registrar General’s Decennial Supplements on Occupational Mortality e before any other country. England has also lead the world in explanatory research, by investing in birth cohort and other longitudinal studies that have contributed hugely to our understanding of the causes of health inequalities. And yet, attempts to reduce health inequalities by systematic policy action seem to have been in vain so far. The Black report, commissioned by a Labour government to investigate the causes and possible remedies for Britain’s undiminished social class inequalities in mortality, proposed a radical change in social and health care policies and as a result disappeared in a desk drawer after the Conservatives won the 1979 elections (Department of Health and Social Services, 1980). When Labour came back into poweralmost20years later, it again commissionedanexpert reporte the Independent Inquiry into Inequalities in Health (Department of Health, 1998) e and rushed into action with a series of policy initiatives which were further elaborated upon in subsequent years. The results have recently been reviewed, but suggest that despite more than 10 years of systematic policy action health inequalities have not narrowed (Department of Health, 2010). Has the English strategy to reduce health inequalities failed? The importance of this question cannot easily be overstated. The explicit and sustained commitment of recent Labour governments to