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Figure 3: Focus of the policies addressing health inequalities.
10 countries presented health inequalities policies that focus on disadvantaged groups of the population thereby acknowledging their vulnerable position without addressing the gap that exists between different socio-economic status group of the population. While Latvia presents health inequalities initiatives as focusing on disadvantaged groups of the population only, Hungary has put special emphasis on the needs of Romas population.
Graham and Kelly [4] have highlighted the fact that even if these approaches might be effective in their attempt to lift the worst-off of the extreme situation in which they are, they only help a relatively small part of the population and may not be sufficient to close the health gap.
7 countries mentioned health inequalities policies that focus on reducing the gap between better-off and worst-off sections of the population. This approach acknowledges the need to make sure that health improvements in the population as a whole are speeded up sufficiently in lower socio economic classes as compared to other groups.
In Northern Ireland for example, tackling health inequalities is part of the current health policy document Investing for Health”. Goals of the programme focus on improving the health of people notably by reducing inequalities in health between geographic area, socio-economic and minority groups.
Although some countries have acknowledged the issue of the health gradient, only Wales and Norway have presented comprehensive health inequalities policies that address the Health Gradient.
Norway has recently published a report The Challenge of the Gradient [5] as a plan of action that outlines future strategies to reduce social inequalities in health.
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[4]Graham, H and Kelly, M Health Inequalities: Concepts, framework and policy. Briefing paper NHS 2004
[5] The Norwegian Directorate for Health and Social Affairs. The Challenge of the Gradient, Plan for Action to reduce social inequalities in Health. May 2005