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The Health Gap



There are dramatic differences in health between countries and within countries.  But this is not a simple matter of rich and poor. A poor man in Glasgow is rich  compared to the average Indian, but the Glaswegian's life expectancy is 8 years  shorter. The Indian is dying of infectious disease linked to his poverty; the  Glaswegian of violent death, suicide, heart disease linked to a rich country's  version of disadvantage. In all countries, people at relative social disadvantage  suffer health disadvantage, dramatically so. Within countries, the higher the  social status of individuals the better is their health.   These health inequalities defy usual explanations. Conventional approaches to  improving health have emphasised access to technical solutions – improved  medical care, sanitation, and control of disease vectors; or behaviours – smoking,  drinking – obesity, linked to diabetes, heart disease and cancer. These approaches  only go so far. Creating the conditions for people to lead flourishing lives, and  thus empowering individuals and communities, is key to reduction of health  inequalities.   In addition to the scale of material success, your position in the social hierarchy  also directly affects your health, the higher you are on the social scale, the longer  you will live and the better your health will be. As people change rank, so their  health risk changes. What makes these health inequalities unjust is that evidence from round the  world shows we know what to do to make them smaller.
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This is the first maximum score for a book covered by the Fun Police!  So if it is not too late for your Christmas shopping, you may want to consider putting this under the tree.  It does not matter that much who you are giving this to, I really believe nearly everyone would benefit  from reading this. Moreover, if you happen to have an uncle or aunt of neo-liberal conviction, he/she may  definitely benefit from some exposure to discussions on inequality and inequity.   I found Professor Marmot’s book to be a very compelling case for more attention to the inequities in  society that directly affect inequities in health. We really should take social determinants in health more  serious, and this resonates directly with the work I am doing. I was also delighted to see a chapter  dedicated to occupational health, which as you may know, encompasses much of my work.  Professor Marmot uses very clear and compelling examples, drawn from all over the world, to illustrate  his arguments, and uses clear language to lay out his argument. As such, this book should appeal to  everyone and is not limited to more academic readers. Each chapter follows a clear argument, which is  discussed in detail so that everyone can follow it, but also is not too long to make it boring or repetitive. I  really enjoyed it (despite it echoing many of the papers I have to read for work, so essentially extending  my working day...). The other good news, at least in my opinion, is that it completely wipes away the arguments in books  such as “The Spirit Level Delusion” (also covered, less favourably, on this site <link>).  So in summary, if you have not read this book yet, you really should!