Poor Britain.
Poor Britain.
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可怜的英国。
DOI：
10.1136/bmj.305.6848.263
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发表时间：
1992
影响因子：
--
通讯作者：
T. Delamothe
中科院分区：
文献类型：
--
作者：
T. Delamothe
失业导致贫困，贫困导致健康状况恶化，其不平等程度比1886年有记录以来的任何时候都要严重。任何挥之不去的怀疑，这种减税优惠更好地受益加剧了家谱在英格兰和威尔士解决了纵向削弱这种不平等：1978-9和1991-2之间的死亡率和社会组织的人研究，得出的结论是，每年收入超过5万英镑的人受益于减税，失业的后果解释了21900英镑的大部分;那些收入低于5000英镑的人只受益于寻找工作的男性所经历的超额死亡率。130.8英镑这些减税措施几乎完全与英国失业率的削减相匹配，因为过去的福利一直在上升。9为了保持经济运转，政府27个月（占劳动力的9-6%）和贫困必须相信，“富人需要更多的钱，而且，正如可以预见的那样，健康状况不佳。英国的困境是穷人自身贫穷的刺激.“'0从伟大的不是唯一的。上周来自该组织的报告再分配宴会穷人已经被送走了空。经济合作与发展组织预测，诚然，政府试图将目标对准那些平均失业率在其成员中将从最大的需求上升，但最近的独立研究表明，1990年的6.2%上升到今年的7.5%。也许主要的经济浪费和普遍的个人困难，”国家的倡议是社会基金，旨在取代一个系统的报告。由于社会凝聚力的风险“战斗的人迫切需要一个法律的权利，紧急财政失业，因此爬到了顶部的帮助。研究人员将该基金比作彩票;他们的政治议程。“在英国，人们的需求没有什么不同，在英国，政治上的关注可以得到帮助，而那些被拒绝的人。I2同样的，很难少。也许这份报告指的是澳大利亚，根据政策研究所的数据，政府改善英国内陆城市的政策失败了。在大多数情况下，“仅仅一个小时”之后，一位阴沉的财政部长宣布，他的政府正在研究让人们返回和住房的方法，如无家可归，失业，贫困，贫困地区至少仍然是被剥夺的工作。在过去的一年中（4-4%），公司将支付所有这些问题的医生，因为贫困和健康状况不佳是培养年轻失业者。英国黑人的官方态度仍然是1980年财政大臣上一次报告中明确确立的，这种联系此后每年都得到证实：失业率上升和经济衰退是价格的“许多研究”。”非熟练工人有25倍的工资，非熟练工人值得支付”来降低通货膨胀率。5（从那时起，一半的妇女几乎是百万人标准化死亡率的两倍，为职业男女通货膨胀率下降1-9%付出了代价。社会阶层梯度存在于他们的工作中。对于那些承受着经济衰退冲击的人来说，不仅是成年人死亡率，还有死产和死亡失业者及其家庭的生活似乎很可能在童年时期就开始了，而且这个梯度一直在变陡。6、更难。面对税收收入的下降和职业死亡率的增加，政府承诺，在社会保障索赔中，62人的66个主要死亡原因在本十年最大的公共支出削减中更为常见，以抑制非熟练和部分熟练的男性;其借贷要求的70个主要原因中有64个。有迹象表明，女性的死亡在其妻子中更为常见。可怜的失业救济金可能在打击名单上。他们的贫穷付出了多少生命的代价。事情还能更糟吗尽管现在已经确立了平均收入一半以上（欧洲共同体的贫困和健康状况不佳）之间的联系，但政府似乎并不相信。从1979年的500万上升到1200万，这是一份126页的白色文件，内容是关于十年后的改善战略;四分之一的英国儿童现在生活在国家健康中，这个主题只占几句话。下议院和其他地方的交流自1979年以来，最贫困的家庭经历了一次削减，不清楚弗吉尼亚·博顿利，收入6%的国务卿，反驳部长声称每个人都有健康，理解为什么这个话题值得在20世纪80年代的繁荣中更详细地分享。事实上，这个讨论。10年见证了战后趋势的逆转，走向了更多政府能做些什么？在最近的几篇论文中，财富的平等分配：现在的收入分配理查德威尔金森认为，
Unemployment begets poverty, which begets ill health more unequal than at any time since records began in 1886.7 and premature death. Any lingering doubts about this Tax cuts preferentially benefiting the better off have exacergenealogy were settled in England and Wales by a longitudinal bated this inequality: between 1978-9 and 1991-2 people study of mortality and social organisation, which concluded earning more than £50 000 a year each benefited by tax cuts of that the consequences of unemployment explain much of the £21 900; those earning less than £5000 benefited by only excess mortality experienced by men seeking work.' £130.8 These tax cuts were matched almost exactly by cuts in Unemployment has been rising in Britain for the past benefits.9To keep the economy ticking over, the government 27 months (to 9-6% of the workforce) and with it poverty must have believed, "the rich needed the spur of more money, and, just as predictably, ill health. Britain's predicament the poor the spur of their own poverty."'0 From the great is not unique. Last week's report from the Organisation redistributive banquet the poor have been sent away empty. for Economic Cooperation and Development predicts that True, the government has attempted to target those in average unemployment among its members will rise from greatest need, but recent independent research suggests that 6 2% in 1990 to 7 5% this year.2 "High unemployment entails some of its key initiatives have failed. Perhaps the main economic waste and widespread individual hardship," states initiative was the social fund, meant to replace a system giving the report. Because of the risk to social cohesion "fighting people with urgent needs a legal right to emergency financial unemployment has therefore climbed to the top of the help. Researchers have likened the fund to a lottery; they political agenda." could find no difference between the needs of people who Not in Britain it hasn't, where political concern could were helped from it and those who were refused."I2 Similarly, hardly be less. Perhaps the report was referring to Australia, government policies to improve Britain's inner cities have where last month's unemployment figures were followed, failed, according to the Policy Studies Institute. On most "barely an hour" later, by a sombre treasurer announcing that measures-such as homelessness, unemployment, poverty, his government was examining ways of getting people back to and housing-the deprived areas remain at least as deprived work.3 Or to Sweden, shocked by a doubling of unemployas they were 15 years ago.'314 ment in the past year (to 4-4%), where companies will be paid All this matters to doctors because poverty and ill health are to train young unemployed people.4 so closely related. Established unequivocally by the Black Britain's official attitude remains that of the chancellor last report in 1980, this association has since been confirmed by year: rising unemployment and the recession are prices "well many studies.'" Unskilled men have 2 5 times and unskilled worth paying" to get inflation down.5 (Since then half a women nearly double the standardised mortality ratios of million people have paid for a 1-9% fall in inflation with professional men and women. A social class gradient exists their jobs.) For those bearing the brunt of the recessionnot only for adult mortality but also for stillbirths and deaths unemployed people and their families-life seems likely to get in childhood, and this gradient has been steepening.'6 In even harder. In the face of falling tax revenues and increasing the most recent survey of occupational mortality 62 of the social security claims the government has promised the 66 major causes of death among men were more common in biggest cuts in public spending this decade to hold down unskilled and partly skilled men; 64 of the 70 major causes of its borrowing requirements. There are suggestions that death in women were more common in their wives.'7 The poor unemployment benefits may be on the hit list. How much pay for their poverty with their lives. worse can things get? The number of people living on less Despite the now well established association between than half average income (the European Community's defipoverty and ill health the government seems unconvinced. In nitionofpoverty) rosefrom five million inl1979 tol12million a its 126 page white paper on a strategy for improving the decade later; a quarter of Britain's children nowlive in nation's health the topic rates just a few sentences.'8 From poverty.6 exchanges in the House of Commons and elsewhere it is Since 1979 the poorest families have experienced a cut of unclear whether Virginia Bottomley, the secretary of state for 6% in income, disproving ministerial claims that everyone has health, understands why the topic warrants more detailed shared in the increased prosperity of the 1980s. In fact, that discussion. decade witnessed a reversal of postwar trends towards a more What could governments do? In several recent papers equal distribution of wealth: the distribution of income is now Richard Wilkinson has argued that the overall standards of