This collection represents an ambitious attempt to assess the impact of the Black Report within the context of revived interest in the persistence of health inequalities in Britain.

It offers an insightful if somewhat brief overview of the historiography and works well as a study in policy making. The volume benefits from the opportunity to interview key actors involved in the project. The sad death of Sir Douglas Black in the final stages of publication underlines the urgency that should be attached to recording similar witness testimonies. For all this, the authors seem to have replicated the strengths and weaknesses of the Black Report itself.

The individual chapters are authoritative, meticulously researched and carefully presented and this volume has happily escaped the major personal and strategy disagreements that so beset the original publication. Instead, there is evidence of broad agreement on the key findings and future directions for research. Careful editing, and attention to the balance between witness testimony and the contextual work, clearly helps here. Yet the critical reader is alert to the problem that the edited collection risks falling into the same trap as the original report in the sense that the attention given to testing the methodology, confirming the detail, and building an interdisciplinary study can crowd out the wider issue of finding solutions to the problem of health inequality.

Contributors to Poor Health discuss the conceptual weaknesses of the Black Report but tend to limit their analysis to its reception in policy-making circles and to assessment of its place within a longer tradition of studying health inequalities. For projects designed to understand inequality, both the Report and this volume seem pre-occupied with strangely esoteric concerns. Thus, while unhappiness about the suppression of the Black Report is registered by some of the contributors, there is very little discussion of the fate of the people condemned to suffer ongoing health inequality by the failure of the Report to
impact on government. Quite simply, the volume is strong on the Black Report, but less so on discussing the ‘social inequality’ included in the title. In many ways, the whole suppression debate simply serves to distract from the gap between what the Black Report set out to achieve and what it actually delivered. Poor Health aims to demystify the project but, by revisiting the arguments, it risks reviving them.

Students today are not unaware of the furore surrounding the 1980 publication, but they are comfortable studying the Black Report as one of a series of investigations examining long-term inequality in health.

As such, this volume contributes to the depth rather than nature of our understanding although, like the report it describes, it claims a more novel approach than it delivers.

Pamela Dale
University of Exeter
doi: 10.1093/shm/hki057