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It is good to see some debate on this list, so I feel I should encourage it. I think the arguments that are coming up on different reasons for interest in inequalities brings us back to the old question on what we mean by equality. So for debate I will put in a few suggestions. As far as I can see equality in outcomes is clearly not possible and not really desirable. Equality meaning people in the same position should be treated in the same way is not desirable because of different preferences and ignores the determinents of illhealth. Equality of resource allocation means inequality in need satisfaction. Equality in need/want satisfaction is an interesting concept but not one I feel anyone has entirely satisfactorily explained, either by neo-classical economists in terms of empirical demand or others in terms of lower and higher level needs. For me the interest lies in highlighting the effects of the vast primarly economic inequalities that exist on health, attempting to understand which policies might minimise the impact and encourage their implementation, and on a more fundamental level challenging the economic inequalities themselves. That is starting of from the impact of the social and economic inequalities. James Woodcock Assistant editor Journal of Evidence Based Health-care >From: "Jeff Green" <[log in to unmask]> >Reply-To: "Jeff Green" <[log in to unmask]> >To: <[log in to unmask]> >Subject: Re: [HEN] Reply to Alex Scott-Samuel >Date: Mon, 14 Aug 2000 23:06:12 +0100 > >Adam et al, > > >I think Alex in his message is > > saying that there are those who want to study inequalities but not >politicise > > them, and those who want to study and politicise them. >Thanks for the translation. > >snip.... > > > But I think there may be a third group of people in > > addition to the two Alex mentioned: a group that believes in reducing >health > > inequality but wants to make sure that they have very good evidence that >a > > programme will reduce health inequality before recommended it for >policy. > >And possibly a fourth.. > >From my perspective as a community pharmacist - I may recognise >inequalities >in health - but still question the necessity for equality. > >I can observe that Asian ladies are less likely to receive HRT (Hormone >Replacement Therapy) but wonder if that inequality should be addressed? > >Is it correct to impose a Eurocentric model of health care onto a culture >which has different values? > >Is it correct for a GP practice to insist on seeing only one patient at a >time when dealing with patients who believe that illness is something that >effects the family and not just the individual? > >Anyway that's where I am coming from. > >Regards > >Jeff Green > >Community Pharmacist. > ________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%