50 years of the inverse care law

The Lancet
Feb 27, 2021 Volume 397 Number 10276 p767-852, e7


50 years of the inverse care law
The Lancet
“The availability of good medical care tends to vary with the need for it in 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.”
These understated opening lines of Julian Tudor Hart’s paper, The Inverse Care Law, are as relevant now (50 years to the day since publication) as in 1971. The paper is one of the landmark publications in The Lancet’s near 200-year history, and the resonance of Tudor Hart’s definition of the inverse care law has global and timeless importance. Simply expressed, Tudor Hart observed that disadvantaged populations need more health care than advantaged populations, but receive less…