This chapter discusses that there is indeed a strong tendency for more unequal societies to have lower average standards of health and shorter life expectancy. An understanding of the effects of inequality on health is particularly relevant to the United States and, to a lesser extent, Britain. The early successes and later failures in the health performance of communist countries provides an interesting angle on the relationship between inequality and health. Although many communist countries were once remarkable for the high standards of health they achieved, in many cases standards fell long before the fall of the communist regimes in 1989. Social status is determined predominantly within a national framework, and income inequality in the whole nation gives some indication of the depth of the social divisions which have such a profound effect on health. People have suggested several ad hoc explanations of the tendency for more egalitarian countries to be healthier.