Introduction

Responding to the new inequalities in health agenda represents a major challenge for all health professions. The government has placed considerable emphasis on reducing health inequalities in key policy papers¹ and has announced targets for action in four key areas. Of particular importance, is the emphasis on tackling the social and material causes of inequalities in health and the commitment to public health.

Literature search and review

There is some evidence that the profession of pharmacy is responding to the public health agenda by attempting to carve out a distinctive niche for itself.^2,3,4 There have been timely reviews of the international literature on the evidence base for pharmacists activities in health development.⁵ There is evidence that pharmacy is beginning to respond to the problems of inequalities in access to health services, through emergency hormonal contraception, smoking cessation and services aimed at addressing drug misuse. ⁵

However, there is less debate concerning pharmacists' contribution to reducing the causes of inequalities in health in society. It is important for pharmacists to have a greater appreciation of how health behaviours are linked to wider social structures since many more pharmacists will be working at strategic level within Primary Care Trusts, in Strategic Health Authorities and as Directors of Public Health. They will have a key role to play in partnership working and commissioning services from health organisations and local government, from statutory and voluntary sectors to deliver the health improvement programme (HimP), the Community Plan and Local Strategic Partnerships (LSPs). Pharmacists will need to understand public health discourse and will require a social scientific understanding of health and health behaviours as well as an awareness of clinical issues.

Discussion

In this presentation, we argue for much greater engagement by pharmacists with inequalities in health. We highlight recent epidemiological and sociological research in this area, describe the scope of pharmacy's response to the health inequalities agenda and discuss some barriers to pharmacy's sustained engagement. We conclude that whilst important work is currently being carried out, it is important for pharmacy to seize the opportunity presented by current government policy and devote more attention to addressing the root causes of inequalities in health.

References

1. Acheson, D. Independent Inquiry into Inequalities in Health (Acheson Report). London: The Stationary Office, 1998.

2. Asghar, M.N. Jackson, C. Corbett, J. (2002) Specialist pharmacists in public health: are they the missing link in England, Pharmaceutical Journal 268: 22-25.

3. Boorman, G. Kalsi, S. Khan, I. Patel, H. (2001) Developing public health pharmacy, Pharmaceutical Journal 266: 572.

4. Walker, R. (2000) Pharmaceutical Public Health: the end of pharmaceutical care? Pharmaceutical Journal vol 264. :340-1.

5. Anderson C, Blenkinsopp A & Armstrong M. Evidence Relating to Pharmacy Involvement in Health Development. Report1: A critical review of the literature 1990-2001. London: RPSGB, 2001.