ABSTRACT
Neither inequalities in health nor policy and practice attention to their causes and consequences are new. In recent Western history this attention has flared brightest when social inequalities have been greatest: the Industrial Revolution of the nineteenth century (during which Rudolf Virchow, whose hagiography introduced this book, was but one of many radical health reformers), the cyclic crises of capitalism leading to severe economic recession or depression such as the ‘Dirty 30s’ (when texts on poverty and health were commonplace), and the worldwide irruptions caused by rapid economic globalisation beginning in the 1980s, accelerated by the collapse of the Soviet Union. Often this attention distils to a patronising concern for the poor, fomenting ideologically driven debates about whether poverty should be considered in absolute or relative terms (empirical evidence supports the importance of both notions although ‘absolute’ poverty elides most closely with the welfare minimalism of today’s free marketers) or what amount of inequality is good or bad for society or the economy as a whole (too much inequality can cause social disintegration and costly policing intervention, too little can dampen entrepreneurial incentives, leading to slower rates of growth; Anderson and O’Neil 2006), though how much growth is environmentally sustainable is a different and vastly more important question usually bracketed in such debates. David Woodward and Andrew Simms of the UK-based New Economics Foundation, as exceptions to this rule, calculate that during 1990-2001, only 0.6 per cent of global economic growth contributed to poverty reduction, compared with 2.2 per cent in the previous decade. Most of the benefits of growth were captured by elites in wealthier countries, yet the environmental costs of that growth were, and continue to be, borne disproportionately by the world’s poor. The evidence, they conclude, firmly establishes wealth redistribution, rather than continued growth, as the most important means for ‘levelling up’ health equity via poverty reduction (Woodward and Simms 2006).
