The contents of this theme section of the Bulletin of the World Health Organization on "Inequalities in health" have two objectives: to present the initial findings from a new generation of research that has been undertaken in response to renewed concern for health inequalities; and to stimulate movement for action in order to correct the problems identified by this research. The research findings are presented in the five articles which follow. This Critical Reflection proposes two initial steps for the action needed to alleviate the problem; other suggestions are given by the participants in a Round Table discussion which is published after these articles. The theme section concludes with extracts from the classic writings of the nineteenth-century public health pioneer, William Farr, who is widely credited as one of the founders of the scientific study of health inequalities, together with a commentary. This Critical Reflection contributes to the discussion of the action needed by proposing two initial steps for action. That professionals who give very high priority to the distinct but related objectives of poverty alleviation, inequality reduction, and equity enhancement recognize that their shared concern for the distributional aspects of health policy is far more important than any differences that may divide them. That health policy goals, currently expressed as societal averages, be reformulated so that they point specifically to conditions among the poor and to poor-rich differences. For example, infant mortality rates among the poor or the differences in infant mortality between rich and poor sectors would be more useful indicators than the average infant mortality rates for the whole population.
PIP: Over the last few years, opinions have shifted towards an increased concern for the health of the poor and for reduction in health inequalities. The contents of the technical papers demonstrate that a promising start has been made to understanding the extent and nature of the problem. This Critical Reflection contains two suggested initial steps for the action needed to alleviate the problem of health inequalities between the better off and the underprivileged. First, professionals giving high priority to the distinct but related objectives of poverty alleviation, inequality reduction, and equity enhancement should recognize that shared concern for the distributional aspects of health policy is far more important than any socioeconomic differences within the society. Second, health policy goals should be reformulated with greater attention to specific health problems of the poor, and towards reducing the differences between the rich and the poor.