Interest in inequalities in health seems to come in cycles in public health literature and activity. There was a peak with the work of Douglas Black of the Black Report in 1980, Margaret Whiteheads "The Health Divide in 1987 and then Marmot but its not clear that the enthusiasm is being maintained. It is difficult to turn around health inequalities brought about by societal structures without reforming social structures and that work is more often undertaken by revolutionaries manning barricades than public health practitioners.
I was interested to come across the concept of micro-inequities as described by Mary Rowe from MIT - tiny almost unnoticeable biases that when accumulated in systems and by people subject to the tiny biases that eventually have a huge system impact. Its kind of like the way cornflake boxes leave the factory with an even distribution of flake size throughout the package but thanks to multiple little road dips and bumps traversed by delivery trucks and forklifts and shelf packing, somehow, all the small cornflakes end up at the bottom of the package. Not so easy to control subtle effects like that in society, maybe that requires a mass cognitive revolution.
