The health divide (1987)

 From the May 1987 issue of the Socialist Standard

In March the Health Education Council brought out its latest — and final — report. The Health Divide: Inequalities in Health in the 1980s. It was released amid a storm of controversy and accusations of an attempted government cover-up. The Council's chairman. Brian Bailey, cancelled a press conference to announce the report, at short notice, saying that the full council had not had time to consider it. He said that its findings could be political dynamite in an election year.

The report illustrates how the poor, especially the unemployed, are more likely to suffer from bad health. The death rate for unemployed men is 36 per cent higher and their wives also die earlier. They are more likely to suffer from deteriorating mental health and lung cancer and suicides are more frequent. There is a substantially higher death rate for children among the poorest 25 per cent of the population. The rate of stillbirths among the top 25 per cent is four per thousand while it is nearly twice that for children in the bottom quarter.

Although people's lifestyles — for instance, smoking and drinking — do influence the figures, by far the biggest impact is caused by material deprivation. Bad housing, "low and inadequate income", overcrowded conditions. pollution and high-rise living are among the main factors which affect people's health. Areas of high unemployment coincide with areas with the worst health records. There are more areas in the north with severe poverty. But there are pockets of prosperity in the north, as well as areas of severe poverty in the south where the health statistics are just as bad. Clearly it is class, not geographical location, which determines people's health.

These figures certainly should be political dynamite in an election year or indeed in any other year. But predictably the response from concerned reformers was as pathetic as the government's claims to be tackling the problem. Douglas Black, the former president of the Royal College of Surgeons, was involved in compiling the report. He advocated more help for mothers-to-be, better child benefit, good school meals, better housing and improved employment. These suggestions fail to confront the cause of the problem and the last one in particular fails to recognise the findings of other reports which show the detrimental effects that employment can have on workers. To suggest that people should kill themselves at work rather than on the dole is not a sensible solution, although it's one the capitalist class and their apologists would welcome.

The most hypocritical response to the report came from Labour's spokesperson on health, Frank Dobson. He said, "The report shows bluntly that poverty kills. Thousands of people would still be alive today if the Tories pursued policies to tackle poverty rather than worsen it”. He concluded. "Our ultimate slogan for the next election will be 'Vote Labour, Live Longer'". But Labour's cries of anguish and horror should be seen in the light of the fact that the gap between the health of the rich and that of the poor also widened during the period of the last Labour government. Poverty was not invented by Thatcher although since the Tories have been in power, and with the increase in unemployment, the gap between rich and poor has widened still further.

The report, and those who commented on it, all stressed that being poor, or as they put it, being part of a "lower social class", was the main factor in bad health. Yet the solutions they offered were various reforms which ignore the cause of this problem and which have failed in the past. The obvious answer would be to put an end to class-divided society in which a small minority live in ease and luxury while many of the rest of us have to endanger our health to make them rich. Capitalism is the real cause of poverty and the poor health that goes with it. It is a diseased, cancerous system that needs revolutionary surgery, not useless elasto-plast reforms.

Ian Ratcliffe