Persistence despite action? Measuring the patterns of health inequality in England (1997-2007)

The persistence of inequalities in health is a major policy concern in England, which was addressed by the new Labour government in 1997 through prioritising the curtailment of health inequalities as a policy goal. However, whether specific interventions have managed to attain their goals is a question for empirical welfare analysis to elucidate. This paper addresses two related questions: first, it empirically examines the dynamic patterns of inequalities in health in England from 1997 to 2007 by estimating concentration indexes of inequality over three measures of health, namely self-reported health, long standing illness and health limitations, calculated across different years of the Health Survey for England. Second, using regression-based decomposition analysis, we explore whether specifically prioritised areas (so-called “spearhead” local authority areas ranked in the bottom fifth on national health indicators) exhibit a different pattern of inequality in the years following a targeted intervention in 2005. Results suggest that patterns of health inequalities in England exhibit moderate variation from 1997 to 2007, although some improvement in self-assessed health inequalities is found. Importantly, patterns of inequality in prioritised (spearhead) areas are not found to be significantly different than health inequalities in non-spearhead areas.