Reducing health inequalities--time for optimism.

101 Health inequalities have been found in all developed countries and for almost all diseases. Marked differences in health status occur between population groups as defined by gender, geography, ethnicity and socio-economic status. For example, affluent, privileged people have better health and lower mortality than poor, disadvantaged people (RACP, 1999). The UK has been tracking the health gap between the rich and the poor for many decades, commencing formally in 1977 with a review chaired by Sir Douglas Black, known as the Black report (Black, 1980; Townsend et al., 1999). Twenty years on, the Blair government set up another expert committee to review progress in dealing with this issue chaired by Sir Donald Acheson (Acheson, 1998). They found that health inequalities had either stayed the same or had widened. Implicit in their review was the criticism that health promotion action had favoured the better off. The Acheson Committee recommended three crucial areas for action.