Accounting for the public's health: an introduction to selected papers from a U.S. conference on "measuring social inequalities in health".

Accounting for, and being accountable to, the public's health requires carefully documenting and analyzing social inequalities in health. Controversies abound over which measures of socioeconomic position to use, at which points in time, and at what level-e.g., individual, household, and neighborhood. Important debates also concern how to analyze these data and relate them to inequalities involving race/ethnicity and gender. Addressing these complex issues is particularly timely in the light of persistent- and even widening- social inequalities in health. To improve tools for evaluating socioeconomic gradients in health, in 1994 the U.S. Public Health Service and National Institutes of Health sponsored a conference on Measuring Social Inequalities in Health. This introduction to the Section on Social Inequalities in Health introduces five articles presented by participants at the conference. Topics include: a historical review of efforts to measure socioeconomic inequalities in health in the U.S. between 1990 and 1950; income dynamics and health; measuring inequalities in health among nonemployed persons; analyzing links between racial/ethnic and socioeconomic disparities in health; and using neighborhood-based socioeconomic data in public health research. Together, these five articles point to a new emphasis on refining methodologies to assess relationships between social position and health and their expression in population patterns of social inequalities in health.