Patterns of health inequalities explained

Chapter 4 (‘Patterns of health inequalities explained’) is based on in-depth studies of the macro-level determinants of health inequalities, especially conducted for this book. It shows that the persistence of health inequalities is partly due to broader changes in society, such as educational expansion, increasing rates of intergenerational mobility, and more intermarriage of highly educated people. Another factor is that health improvements have been faster in higher than in lower socioeconomic groups, also because higher socioeconomic groups have benefited more from rising prosperity and rising health care expenditure, and have suffered less negative health impacts from rising income inequality and the transition towards liberal democracy in Central and Eastern Europe. Finally, it demonstrates the importance of the continued social patterning of health determinants, particularly poverty and smoking. It ends with a summary of how differences in the magnitude of health inequalities between European regions (North, South, East) should be understood.