Black Report


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Black Report

the report of the Working Group on Inequalities in Health chaired by Sir Douglas Black, Chief Scientist at the Department of Health and President of the Royal College of Physicians which was published in 1980. A more accessible version was published as Inequalities in Health by Peter Townsend and Nick Davidson. The Black Report reviewed UK health statistics (MORBIDITY RATE and MORTALITY RATE and access to health care services) and compared them with figures for other EC and Scandinavian countries. It found:
  1. at all ages male mortality rates are greater than female mortality rates;
  2. the gap between the mortality rates of employed men in classes I and IV had increased between 1949 and 1972;
  3. the mortality rates for men in classes III, IV and V deteriorated or stayed the same in this period, but relative to the combined mortality rates of classes I and II they had increased;
  4. the picture of female mortality was similar, a deterioration for married and single women in the most numerous category, class IV;
  5. a reduction in deaths per 1000 live births for all groups, but a relative excess in classes IV and V combined, over classes I and II combined, between 1959 and 1972;
  6. a decline in maternal mortality for all groups, but a persistent class differential;
  7. no significant improvements in the life expectancy and life chances of children up to the age of 14 from all classes.

The Report found that there was a class gradient in illness and mortality, and that this gradient was replicated in a stratified access to, and use of, health-care facilities. The conclusion was that the significant factors affecting health were income, occupational characteristics, education, housing and lifestyle, all of which lie beyond the power of the NHS to change.

The committee made a number of far-reaching policy recommendations which concentrated on three areas:

  1. improved facilities and resources for the health of mothers and children;
  2. priority for disabled people in order to improve the quality of their lives in general, allow them to be cared for in their own homes, and to reduce the risk of them needing institutional care;
  3. priority for preventative and educational action to encourage good health and discourage unhealthy habits like smoking.

The overall conclusion, however, was that without a government strategy to reduce poverty, none of these recommendations would be entirely effective.