University of Newcastle upon Tyne, UK.
J Health Psychol. 1997 Jul;2(3):413-25. doi: 10.1177/135910539700200309.
A crucial, but unexamined, assumption motivating research into socio-economic health differentials is that such differentials are unjust. An equal distribution of health, as well as of economic resources, is regarded as the proper goal of policy. I suggest that this assumption of 'the inequity of inequality' has its basis in 'human nature'. Sustained selection pressures operating in immediate-return nomadic hunter-gatherer societies led to the evolution of 'counterdominant' behaviours in order to promote cooperation and social living. Modem humans have therefore inherited 'egalitarian instincts' that are activated when inequalities of resources (and of health) are personally encountered. This activation is qualitative, and amelioration of differentials that fall short of equality would not necessarily diminish perceived injustice. Rather than attempting to adjust the abstract statistical measures of economic and health differentials derived from population data, the goal of policy should be to address the subjective experience of the inequity of inequality at the level of individuals.
一个关键但未被检验的假设，是推动社会经济健康差异研究的动力，即这种差异是不公正的。健康和经济资源的平等分配被视为政策的恰当目标。我认为，这种“不平等的不平等”假设的基础是“人性”。在即时回报的游牧狩猎社会中持续的选择压力导致了“反主导”行为的进化，以促进合作和社会生活。因此，现代人类继承了“平等主义本能”，当个人遇到资源（和健康）不平等时，这种本能就会被激活。这种激活是定性的，而且差异的改善，如果没有达到平等，不一定会减少感知到的不公正。政策的目标不是试图调整从人口数据中得出的经济和健康差异的抽象统计衡量标准，而是应该在个人层面上解决不平等的不公正性的主观体验。
