The Black Report 1980

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The publication of the Black Report over the Bank Holiday Weekend of 1980 by the Thatcher Government signalled the end of the hopes of improvement in public health for twenty years. It was clear that the Government would have preferred to suppress the whole thing, and it is greatly to the authors’ credit that this did not happen. However you do not need to read very much to see why the Conservatives wanted to suppress it. Redistribution, increased public expenditure and taxation and unashamed socialism are flaunted on almost every page.

Virginia Berridge has given an account of how the report was set up and how the report was written and published THE BLACK REPORT: INTERPRETING HISTORY .

SHA Conference: The Black Report – 25 Years On Manchester Friday 9th September 2005

The Black Report
The Black Report 1980

The Socialist Health Association has one of about 260 duplicated copies. An updated version was later produced by Penguin books but this is a scanned copy of the original text which was produced on stencils. An attempt has been made to correct typographical errors, which are many, and some of the footnotes have been inserted into the text. The graphs are largely as they appear in the original.

Contents

Foreword

INTRODUCTION INEQUALITIES AND HEALTH

CHAPTER 1 CONCEPTS OF HEALTH AND INEQUALITY

  • Approaches within medicine, epidemiology and sociology
  • The choice of indicators of health and ill-health – Concepts of inequality and social class
  • The problems of choosing indicators of inequality
  • Conclusion

CHAPTER 2 THE EVIDENCE OF INEQUALITIES IN HEALTH

  • The pattern of health inequality in contemporary Britain
  • Mortality and morbidity: the sources of data
  • Occupational class and morbidity through the life cycle
  • Conclusion

CHAPTER 3 TRENDS IN INEQUALITY OF HEALTH

  • Decline in death rates
  • Morbidity
  • Inequalities and distribution
  • Conclusion

CHAPTER 4 THE EVIDENCE FOR INEQUALITY IN HEALTH SERVICE AVAILABILITY AND USE

CHAPTER 5 HEALTH INEQUALITIES: INTERNATIONAL COMPARISONS

  • Levels of health and changes over time
  • Inequalities in health USA – the reduction of inequality?
  • Conclusions

Chapter 6 EXPLANATION OF HEALTH INEQUALITIES

  • Theoretical approaches
  • Towards explanation of the evidence of health inequalities
  • Conclusions

CHAPTER 7 THE NEED FOR ADDITIONAL INFORMATION AND RESEARCH

  • sources of information relating to health and need for care
  • Sources of information relating to use of health services
  • Further recommendations
  • Conclusion and recommendations

CHAPTER 8 POLICIES TO REDUCE INEQUALITIES OF HEALTH (1) PLANNING THE HEALTH AND PERSONAL SOCIAL SERVICES TO REDUCE INEQUALITIES: AND A DISTRICT ACTION PROGRAM

  • The definition of objectives and principles
  • Planning
  • Resource allocation
  • A district action programme
  • A programme for 10 special areas
  • Conclusion and Summary of recommendations

CHAPTER 9 POLICIES TO REDUCE HEALTH INEQUALITIES; (2) A WIDER STRATEGY

A A policy for families and children

  • Child benefit
  • Infant care allowance
  • Pre-school education and day care
  • Nutrition – school milk and meals
  • Accidents to children
  • Policy for families and children – costs and a possible source of revenue

B Policy measures affecting households without as well as with children

  • A comprehensive disablement allowance
  • Working conditions
  • Housing

C Towards a coordinated policy in Government for reducing health inequalities

  • Conclusion and summary of recommendations

SUMMARY OF REPORT AND RECOMMENDATIONS

APPENDICES (not reproduced)

APPENDIX I Use of the General Household Survey for the analysis of inequalities in Health.

APPENDIX 2 Gateshead AHA – Health Service Problems 1979

APPENDIX 3 Plans and Priorities for Tower Hamlets1979-1984.

APPENDIX 4 Deaths 1970-72 in Classes IV and V and deaths if rates for Class I had applied (1970-72) England and Wales

APPENDIX 5 General Household Survey Tables

APPENDIX 6 Wealth and Income Tables

APPENDIX 7 The Build up of a revenue target

APPENDIX 8 Resource allocation: Secretary of State’s instructions to RHAs. Letters of Feb 1977 and 1978

APPENDIX 9 Illustration of variation in Mortality and hospital admission in relation to occupational class.