Nesta hora que tanto se discute deficiências na Assistência à Saúde/Doença, vai ser bom reler o texto de 1971 deste meu amigo Julian Tudor Hart, que imagino esteja bem de saúde porque há pouco tempo recebi dele um e-mail dando novo endereço porque hackers haviam invadido o computador dele. Quem me fez relembrá-lo foi a AMICOR Maria Inês Reinert Azambuja.;

The Inverse Care Law

The Lancet:  Saturday 27 February 1971

JULIAN TUDOR HART

Glyncorrwg Health Centre, Port Talbot, Glamorgan, Wales 

Summary

The availability of good medical care tends to vary inversely with the need for the population served.  This inverse care law operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced.  The market distribution of medical care is a primitive and historically outdated social form, and any return to it would further exaggerate the maldistribution of medical resources.

Interpreting the Evidence

The existence of large social and geographical inequalities in mortality and morbidity in Britain is known and not all of them are diminishing.  Between 1934 and 1968, weighted mean standardised mortality from all causes in the Glamorgan and Monmouthshire valleys rose from 128% of England and Wales rates to 131%.  Their weighted mean infant mortality rose from 115%  of England and Wales rates to 124% between 1921 and 1968.1[1] The Registrar General’s last Decennial Supplement on Occupational Mortality for 1949-53 showed combined social classes I and II (wholly non-manual), with a standardised mortality from all causes ­18% below the mean, and combined social classes IV and v (wholly manual) 5% above it. Infant mortality was 37% below the mean for social class I (professional) and 38% above it for social class V unskilled manual)./.../