This chapter looks at inequalities in health within and between nations, as well as changing patterns of health inequality through time. It begins to consider possible explanations for such inequalities in terms of social and economic forces and developments.

Inequalities in health between countries

As Hilary Graham explains in her incisive study of health and socio-economic inequalities, Unequal Lives (2007), most of the evidence showing how individual health is shaped by social circumstances comes from richer, developed countries. This is because of the lack of effective national data collection systems in poorer countries and the uneven distribution of funding for research into health outcomes, with less than 10% of all such funding by the public and private sectors devoted to investigation of the health of the poorer 90% of world population.

There is now considerably more, and more reliable, data on child health in low and middle income countries, than on adult health, with ‘death rates among children under the age of 5’ generally recognised as ‘more reliable than othermeasures of population health’ for such countries (Graham, 2007, p. 65).