While health inequalities among older people have long been a research focus and are now high on policy agendas in developed societies, they have often been neglected in less developed ones, despite them experiencing rapid population ageing since the turn of the century. Using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) cohort study (N = 63,578), this paper measures the health status of older people using the Quality of Well-Being scale, and estimates time trends in health inequality with concentration indices, followed by an investigation of their social determinants. Its specific focus is health care accessibility (HA) in the period 2005–2018, when China experienced an unprecedented advance in health-related social policy reform. The analysis reveals pro-rich inequalities in health among older people, but also shows that these have narrowed gradually over the past two decades, which is largely attributable to greater equity in access to health care. Within this general trend of inequality reduction, however, the role of HA has declined and social determinants such as education now have an increasing influence on health inequalities. These findings suggest that social policies targeting not only health improvements among older people but also health inequalities earlier in the life course are required if policy makers want to promote health equity in later life.

The aim of this study was to analyze inequalities in the prevalence of poor mental health and their association with socioeconomic variables and with the care network in the Autonomous Communities in Spain. A cross-sectional multilevel study was performed, which analyzed individual data from the National Health Survey in Spain (ENS), in 2006 (n = 29,476 people over the age of 16). The prevalence of poor mental health was the dependent variable, measured by the General Health Questionnaire (GHQ-12 > = 3). Individual and contextual socioeconomic variables, along with mental health services in the Autonomous Communities, were included as independent variables. Models of multilevel logistic regression were used, and odds ratios (OR) were obtained, with confidence intervals (CI) of 95%. The results showed that there are inequalities in the prevalence of poor mental health in Spain, associated to contextual variables, such as unemployment rate (men OR 1.04 CI 1.01–1.07; women OR 1.02 CI 1.00–1.05). On the other hand, it was observed that inequalities in the mental health care resources in the Autonomous Communities also have an impact on poor mental health.

Devolved accountability for primary care has been introduced into the UK through a range of local contracts for personal medical services (PMS) authorized by the 1997 NHS (Primary Care) Act. These four exemplary case studies illustrate the PMS pilot programmes and represent a diversity of emerging organizational developments that appear to be responding effectively to different health care needs and environments. This is particularly apparent at those sites targeting the most marginalized patient groups where interprofessional collaboration and interagency partnerships are characteristic of a new and broader primary health care approach. Elsewhere the PMS pilots retain and indeed may extend some of the more restrictive practices of the conventional primary medical care model. Future policy formulation, therefore, needs to promote flexible management structures and processes which can support, through local contracts, the further development of more comprehensive and population-based primary care.