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Thursday, November 26, 1998 Published at 18:09 GMT


Health

The Acheson report up close

The Acheson report shows the link between health and mortality

A government-commissioned report on health inequalities will provide "a key influence" on future public health policy in the UK, according to Health Secretary Frank Dobson.

Sir Donald Acheson's report highlights a range of areas where health inequalities can be reduced. News Online details four of these:

Benefits

The report calls for an increase in benefit levels for women of childbearing age, expectant mothers, young children and older people.

It says poverty has a disproportionate effect on children. In the mid 1990s, around a quarter of people in the UK were living below the poverty level.


[ image: Poor nutrition in pregnant mothers affects the health of the foetus]
Poor nutrition in pregnant mothers affects the health of the foetus
But among children, the figure was one in three.

The report says children under two are more expensive to look after than older children, but Income Support levels do not reflect this.

It says benefits underestimate the cost of providing a basic standard of living for single parents.

And it states that many people on low incomes do not have enough money to buy the items and services necessary for good health, meaning that money for food is often used to meet emergencies.

Mothers are sometimes forced to go without food as a result.

The report says many pregnant women on Income Support have inadequate diets, especially single women under 25.

Education

The report calls for more funding for schools in deprived areas, better nutrition at schools and "health promoting schools".

These promote health through the curriculum, for example, by teaching children not just about cooking, but also about budgeting for food.

The report also proposes that schools should offer pupils free fresh fruit and avoid putting sweet machines on the premises.

They should also promote parenting and relationship classes and programmes on substance abuse and sex education.

It says children from disadvantaged backgrounds achieve less at school than other children and are more likely to go on to get badly paid jobs or be unemployed.

This leads to a vicious circle of health problems associated with low income and a perpetuation of the poverty trap.

The report says reduced entitlement to free school meals and the selling off of school playing fields have have a bad impact on children's health.

About 15% of children in England receive a free school lunch. Entitlement is based on whether their parents are on benefits.

Babies

The report reiterates concerns about benefit levels and education about the need for nutritional meals as well as calling for policies for an end to "food deserts".

These are deprived estates where access to affordable fresh food is difficult because of poor public transport links.

The report says babies whose fathers are in lower social groups are on average 130 grams lighter than those with fathers in the top social groups.

Babies whose mothers were born in south Asia are on average 200 grams lighter than those born to mothers born in the UK.

Low-weight babies are more likely to suffer from heart disease and related illnesses in later life.

Children of women who are overweight are also at increased rate of coronary heart disease as adults.

The report says poor women are more likely to be obese than the rich. Twenty-five per cent of women in lower social classes are obese compared 14% of professional women.

Smoking and drinking

The report calls for restrictions on smoking in public places, a ban on tobacco advertising and promotion, mass educational initiatives, increases in the price of tobacco and the prescribing of nicotine replacement therapy on the NHS.


[ image: The poor are more likely to smoke and less likely to be able to quit]
The poor are more likely to smoke and less likely to be able to quit
The poorer you are the more likely you are to smoke, says the report.

In 1996, 29% of men and 28% of women smoked, but only 2% of professional men and 11% of professional women smoked, compared with 41% of unskilled male workers and 36% of unskilled women workers.

Richer people also smoke fewer cigarettes than the poor, are less likely to be addicted to cigarettes and more able to give up smoking.

Since 1973, the number of rich people who stop smoking has doubled from 25% to 50%.

Around 9% of poor people gave up smoking in 1973. That figure had only risen to around 13% in 1996.

Moreover, the number of people who smoke in the UK has fallen in recent years, but the number of poor people who smoke has remained stable.

The report says: "Smoking is an important component of differences in mortality between social classes."

Smoking is the highest single risk factor for cancer in the UK.

The poor are also twice as likely to have drink problems as the rich. Seventeen per cent of poor men and 6% of poor women has an alcohol problem, compared with 8% of rich men and 3% of rich women.



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