Inequalities in health. The Black Report: a summary and comment

In August 1980 the United Kingdom Department of Health and Social Security published the Report of the Working Group on Inequalities in Health, also known as the Black Report (after chairman Sir Douglas Black, President of the Royal College of Physicians). The Report showed in great detail the extent of which ill-health and death are unequally distributed among the population of Britain, and suggested that these inequalities have been widening rather than diminishing since the establishment of the National Health Service in 1948. The Report concluded that these inequalities were not mainly attributable to failings in the NHS, but rather to many other social inequalities influencing health: income, education, housing, diet, employment, and conditions of work. In consequence, the Report recommended a wide strategy of social policy measures to combat inequalities in health. These findings and recommendations were virtually disowned by the then Secretary of State for Social Services, very few copies of the Report were printed, and few people had the opportunity to read it. The Black Report is an important document that deserves wide attention and debate. This summary and comment is intended to give greater access to its evidence, arguments, conclusions, and recommendations.