Modernising the NHS

May 18, 2000

Prevention and the reduction of health inequalities

In the second of seven BMJ articles on the modernising of the NHS, Sally Macintyre, Director of the MRC Social and Public Health Sciences Unit at the University of Glasgow, argues that the modernisation action team dealing with health inequality should review progress and act on the existing public health reports, notably the Acheson report. Professor Macintyre says that most of the factors which exacerbate health disadvantage, such as air pollution, unemployment, crime and disorder, poor housing, low educational achievement and poverty lie outside the control of the NHS. Some of the extra resources coming on stream should therefore be spent in partnership with organisations outside the NHS.

Professor Macintyre highlights the growing health gap between rich and poor. The healthy life expectancy of rich people is increasing faster than that of the poor who may find it more difficult to respond to health promotion strategies on smoking, diet and exercise. Dr Macintyre says it would be disappointing if the action team is confined to exhorting people to change their behaviour. "The action team should focus upstream on ....what is pushing people into the river as well as downstream .... pulling drowning people out of the river."
Contact :

Sally Macintyre, MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow G12 8RZ Note: Professor Macintyre is away from Weds 17 May, but Graham Hart in the unit will take press calls, or contact the BMJ press office for help Email :


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