I agree with much of what you say, John: but I would
emphasise the crucial importance of your concluding
sentence -
> I think this sort of discussion
> is crucial in helping us move our agenda forward.
While I would certainly accept that, in the US, reaching
consensus around the definition of inequity and inequality
is important, my quarter-century in UK inequalogy has
taught me that, after a reasonable period of discussion,
continuing debate about definitions of inequality and about
whether inequalities really exist can be very diversionary.
The same is true regarding focusing on outcomes: while we
are busy getting excited about small changes in CHD
mortality among the poor, they are continuing to die
prematurely from other causes. Class inequalities tend to
continue irrespective of cause-specific outcomes. It's the
exposures that require our attention - the ways in which our
unequal societies systematically neglect to take care of
their disadvantaged members.
Another realisations that comes with time is that
inequalogists divide up into two types - those for whom
equity is a value and those for whom it is an interesting
subject for research and / or policy. The latter are of
course those who prolong the debates about definitions and
strategies well beyond their sell-by dates.
Best wishes, Alex
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Alex Scott-Samuel
EQUAL (Equity in Health Research and Development Unit)
Department of Public Health
University of Liverpool
Whelan Building
Quadrangle
Liverpool
L69 3GB
Tel (+44)151-794-5569
Fax (+44)151-794-5588
e-mail [log in to unmask]
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