Inequalities in health: Strategies

It is the purpose of this article to identify strategies of overcoming inequalities in health. However, equality in health is a goal hardly to be achieved in unequal societies. In addition, the perception of as well as action against health inequalities depend highly on the underlying paradigms of health and disease. Therefore, three models (the traditional medical, the epidemiological as well as the socio-political model) of health are discussed. The second part shows structural tendencies and new strategies. Structural tendencies like professionalization, bureaucratization, medicalization as well as sophisticated technologies are likely to aggravate already existing inequalities whereas the impact of new approaches is not so certain. The primary health care program as a strategy formulated by WHO could be a viable approach to overcome health inequalities. This holds also for a great variety of policy oriented proposals contained in the 'Black Report' in Great Britain. Basic organizational concepts or prerequisites for an egalitarian health policy as functional integration of health and social services, interdisciplinary cooperation, the necessary link between theory and practice in health programs as well as the various approaches of community participation are also discussed in this article. In a selective way the important problem areas of particular social and political concern are dealth with: youth and health as well as workers' health.