Originally published in 1986, this book discusses issues such as social class differences in health; the effect of unemployment on health; the relationship between income and health; how much of the class differences in death rates can be explained in terms of medically recognized factors. Presenting empirical research to resolve these issues, the book takes health to the centre of the political stage and raises fundamental issues about the direction of modern economic and social development and its impact on inequality. As relevant now as when it was first published the book reviews twenty of the most important longitudinal studies in the area of health and class that had been carried out in the UK at the time.

Among the developed countries it is not the richest societies which have the best health, but those which have the smallest income differences between rich and poor. Inequality and relative poverty have absolute effects: they increase death rates. But why? How can smaller income differences raise average life expectancy?
Using examples from the USA, Britain, Japan and Eastern Europe, and bringing together evidence from the social and medical sciences, Unhealthy Socities provides the explanation. Healthy, egalitarian societies are more socially cohesive. They have a stronger community life and suffer fewer of the corrosive effects of inequality. As well as inequality weakening the social fabric, damaging health and increasing crime rates, Unhealthy Societies shows that social cohesion is crucial to the quality of life.
The contrast between the material success and social failure of modern societies marks an imbalance which needs attention. The relationship between health and equality suggests that important social needs will go unmet without a larger measure of social and distributive justice. This path-breaking book is essential reading for health psychologists, sociologists, welfare economists, social policy analysts and all those concerned with the future of developed societies.

Originally published in 1973 and now reissued with a new Preface, this striking book challenges the whole structure of our thinking on how societies develop - why some are primitive and others advanced. It demonstrates that the pursuit of progress is not the real driving force behind change. Economic development, it argues, is simply the escape route of societies caught in the ecological pincers of population growth and scarce resources. The author explains the processes by which industrialization is forced upon societies by the progressive scarcity of all land-based resources. The things we think of as the fruits of man's search for progress including increasingly sophisticated technology, labour-saving machinery and the rest - are in fact part of the struggle to keep up with the growing productive task created by ecological pressures. ln this light primitive societies appear less poor than we imagine, and advanced ones less rich.

Among the developed countries it is not the richest societies which have the best health, but those which have the smallest income differences between rich and poor. Inequality and relative poverty have absolute effects: they increase death rates. But why? How can smaller income differences raise average life expectancy?
Using examples from the USA, Britain, Japan and Eastern Europe, and bringing together evidence from the social and medical sciences, "Unhealthy Socities" provides the explanation. Healthy, egalitarian societies are more socially cohesive. They have a stronger community life and suffer fewer of the corrosive effects of inequality. As well as inequality weakening the social fabric, damaging health and increasing crime rates, "Unhealthy Societies" shows that social cohesion is crucial to the quality of life.
The contrast between the material success and social failure of modern societies marks an imbalance which needs attention. The relationship between health and equality suggests that important social needs will go unmet without a larger measure of social and distributive justice. This path-breaking book is essential reading for health psychologists, sociologists, welfare economists, social policy analysts and all those concerned with the future of developed societies.

Why do people in more unequal societies have worse health and shorter lives? And why are levels of violence higher and community life weaker where there is more inequality? In this book, pioneering social epidemiologist Richard Wilkinson shows how inequality affects social relations and well-being. In wealthy countries, health is not simply a matter of material circumstances and access to health care; it is also how your relationships and social standing make you feel about life. Using detailed evidence from rich market democracies, the book addresses people's experience of inequality and presents a radical theory of the psychosocial impact of class stratification. The book demonstrates how poor health, high rates of violence and low levels of social capital all reflect the stresses of inequality and explains the pervasive sense that, despite material success, our societies are sometimes social failures. What emerges is a new conception of what it means to say that we are social beings and of how the social structure penetrates our personal lives and relationships.

In this book, pioneering social epidemiologist Richard Wilkinson, shows how inequality affects social relations and well-being. In wealthy countries, health is not simply a matter of material circumstances and access to health care; it is also how your relationships and social standing make you feel about life. Using detailed evidence from rich market democracies, the book addresses people's experience of inequality and presents a radical theory of the psychosocial impact of class stratification. The book demonstrates how poor health, high rates of violence and low levels of social capital all reflect the stresses of inequality and explains the pervasive sense that, despite material success, our societies are sometimes social failures. What emerges is a new conception of what it means to say that we are social beings and of how the social structure penetrates our personal lives and relationships.

Eswar ein besonderes Privileg fur mieh, in denvergangenen zwanzig ahren tiber die bestimmenden sozialen und wirtsehaftliehen Fakto ren im Gesundheitswesen arbeiten zu durfen, Angefangen hat alles mit einem Zeitungsartikel, den ieh 1976 naeh Beendigung meiner Magisterarbeit in Form eines offenen Briefes an den damaligen Mi nister fur Gesundheit und Soziales David Ennals in der Labour-Re gierungvon Callaghanrichtete. ' Mitdem Hinweis, dass er alsLabour Minister die damalsbekannten groBten sozialen Klassenuntersehiede in Bezugaufdie Sterbliehkeitverwalte, forderte ieh ihn auf, eine"dring liehe Anfrage" einzubringen. Drei Monate spater, naeh Lekture mei nes Artikels, kundigte er dieEinsetzungeinerArbeitsgruppe des Mi nisteriums unter dem Vorsitz von Sir Douglas Black an. Drei Jahre spater brachte diese den Black-Report mit dem Titel "Inequalitiesin Health "heraus und lautete damit eine neueArazur Erforschungder sozialen Ursachen von Gesundheit und Krankheit in der entwickel ten Welt ein. Sir Douglas Black, ChiefMedical Officer (Anm. d. Obs.: hochster medizinischer Beamter) in David Ennals Ministerium, be sehrieb seinen Minister- mit fur ihn charakteristischenWorten - als "einen Menschen, der versuchte, Gutes zu tun, und alles in allem Erfolg hatte," Die durch diesen Bericht angeregte Forschung verandert seitdem standig das Bild, das wir uns von der Gesellschaft wie auch von der Gesundheit machen. Nach einer Anfangsphase, in der es urn Fragen derGlaubwiirdigkeitdergrundlegenden Zahlen ging, mutetederwis senschaftlicheFortschrittwie ein langer, schwierigerAufstieg an, nun eroffnetsich unsjedochder erste Blickaufdie vorunsliegende Land schaft. Waswirjetztsehenkonnen, istdazubestimmt, die Sozial- und Wirtschaftspolitik- unddamithoffentlichauch die Richtungder so- Vorwort XXII zialen Entwicklung moderner Gesellschaften - zu verandern."