Unwinding Inequality

I once attended a workshop of epidemiologists discussing why it was that richer and better-educated people lived longer than poorer and less educated people, something they regarded as a great injustice. I asked them about the Surgeon General’s famous 1964 report on the hazards of smoking. It saved a lot of lives, but better-educated people got the message first, so it had the unintended effect of creating inequalities in health. Given a time machine, would they go back and suppress the report? To my surprise, their response was, “Well, that’s a hard one.” If we’d taken a vote, I’m pretty sure the Surgeon General would have lost.