In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

'Punchily written ... He leaves the reader with a sense of the gross injustice of a world where health outcomes are so unevenly distributed' Times Literary Supplement 'Splendid and necessary' Henry Marsh, author of Do No Harm, New Statesman There are dramatic differences in health between countries and within countries. But this is not a simple matter of rich and poor. A poor man in Glasgow is rich compared to the average Indian, but the Glaswegian's life expectancy is 8 years shorter. The Indian is dying of infectious disease linked to his poverty; the Glaswegian of violent death, suicide, heart disease linked to a rich country's version of disadvantage. In all countries, people at relative social disadvantage suffer health disadvantage, dramatically so. Within countries, the higher the social status of individuals the better is their health. These health inequalities defy usual explanations. Conventional approaches to improving health have emphasised access to technical solutions – improved medical care, sanitation, and control of disease vectors; or behaviours – smoking, drinking – obesity, linked to diabetes, heart disease and cancer. These approaches only go so far. Creating the conditions for people to lead flourishing lives, and thus empowering individuals and communities, is key to reduction of health inequalities. In addition to the scale of material success, your position in the social hierarchy also directly affects your health, the higher you are on the social scale, the longer you will live and the better your health will be. As people change rank, so their health risk changes. What makes these health inequalities unjust is that evidence from round the world shows we know what to do to make them smaller. This new evidence is compelling. It has the potential to change radically the way we think about health, and indeed society.

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.

Social justice has always been a core value driving public health. Today, much of the etiology of avoidable disease is rooted in inequitable social conditions brought on by disparities in wealth and power and reproduced through ongoing forms of oppression, exploitation, and marginalization. Tackling Health Inequities raises questions and provides a starting point for health practitioners ready to reorient public health practice to address the fundamental causes of health inequities. This reorientation involves restructuring the organization, culture and daily work of public health. Tackling Health Inequities is meant to inspire readers to imagine or envision public health practice and their role in ways that question contemporary thinking and assumptions, as emerging trends, social conditions, and policies generate increasing inequities in health.

A groundbreaking investigation of how inequality infects our minds and gets under our skin Why are people more relaxed and at ease with each other in some countries than others? Why do we worry so much about what others think of us and often feel social life is a stressful performance? Why is mental illness three times as common in the USA as in Germany? Why is the American dream more of a reality in Denmark than the USA? What makes child well-being so much worse in some countries than others? As The Inner Level demonstrates, the answer to all these is inequality. In The Spirit Level Richard Wilkinson and Kate Pickett put inequality at the center of public debate by showing conclusively that less equal societies fare worse than more equal ones across everything from education to life expectancy. The Inner Level now explains how inequality affects us individually, altering how we think, feel and behave. It sets out the overwhelming evidence that material inequities have powerful psychological effects: when the gap between rich and poor increases, so does the tendency to define and value ourselves and others in terms of superiority and inferiority. A deep well of data and analysis is drawn upon to empirically show, for example, that low social status leads to elevated levels of stress hormones, and how rates of anxiety, depression and addictions are intimately related to the inequality which makes that status paramount. Wilkinson and Pickett describe how these responses to hierarchies evolved, and why the impacts of inequality on us are so severe. In doing so, they challenge the conception that humans are inescapably competitive and self-interested. They undermine, too, the idea that inequality is the product of "natural" differences in individual ability. This book draws together many of the most urgent problems facing societies today, but it is not just an index of our ills. It demonstrates that societies based on fundamental equalities, sharing and reciprocity generate much higher levels of well-being, and lays out the path towards them.