What does the empirical evidence tell us about the injustice of health inequalities?
Angus Deaton, Center for Health and Wellbeing
Available online PDF [26p.] at: http://bit.ly/fE0plY
“……Whether or not health inequalities are unjust, as well as how to address them, depends on how they are caused. I review a range of health inequalities, between
men and women, between aristocrats and commoners, between blacks and whites, and between rich and poor within and between countries. I tentatively identify
pathways of causality in each case, and make judgments about whether or not each inequality is unjust.
Health inequalities that come from medical innovation are among the most benign. I emphasize the importance of early life inequalities, and of trying to moderate the link between parental and child circumstances. I argue that racial inequalities in health in the
“……….How we should think about inequalities in health depends, in part, on the facts about health inequalities, and on how we understand them. Causal interpretations
are required to design policy. Hausman (2009, 237) notes that “understanding the health gradient helps to guide benevolent interventions” and emphasizes the need to clarify causal paths.
Facts and correlations, without an understanding of causation, are neither sufficient to guide policy nor to make ethical judgments.
Without getting causation right, there is no guarantee that interventions will not be harmful. It is also possible that an inequality that might seem to be prima facie
unjust might actually be the consequence of a deeper mechanism that is in part benevolent, or that is unjust in a different way. I provide examples of good inequalities…………
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