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In July 1997, shortly after the election of the new Labour government in the UK, the Secretary of State for Health asked Sir Donald Acheson, the recently retired Chief Medical Officer, to head an inquiry into inequalities in health in England and identify priority areas for policies to reduce inequalities.
Sir Donald Acheson's report adopts a broad socioeconomic model of health and inequalities.1 This model places individuals at the centre of many layers of conditions that determine their health, for example, their lifestyle, social and community networks, living conditions, and general socioeconomic conditions. As well as examining physical and mental health, the inquiry team sought evidence of the effects of unemployment, low income, housing, transport, and education.
There are two overarching recommendations. First, that as part of health impact assessments, all policies likely to have a direct or indirect effect on health should be evaluated in terms of their impact on health inequalities. They should be formulated in such …