'Punchily written ... He leaves the reader with a sense of the gross injustice of a world where health outcomes are so unevenly distributed' Times Literary Supplement 'Splendid and necessary' Henry Marsh, author of Do No Harm, New Statesman 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. This new evidence is compelling. It has the potential to change radically the way we think about health, and indeed society.

Why do Oscar winners live for an average of four years longer than other Hollywood actors? Who experiences the most stress - the decision-makers or those who carry out their orders? Why do the Japanese have better health than other rich populations, and Keralans in India have better health than other poor populations - and what do they have in common? In this eye-opening book, internationally renowned epidemiologist Michael Marmot sets out to answer these and many other fascinating questions in order to understand the relationship between where we stand in the social hierarchy and our health and longevity. It is based on more than thirty years of front-line research between health and social circumstances. Marmot's work has taken him round the world showing the similar patterns that could be affecting the length of your life - and how you can change it.

The Strategy of Preventive Medicine by Geoffrey Rose, first published in 1993, remains a key text for anyone involved in preventive medicine. Rose's insights into the inextricable relationship between ill health, or deviance, in individuals and populations they come from, have transformed our whole approach to strategies for improving health. His personal and unique book, based on many years research, sets out the case that the essential determinants of the health of society are to be found in its mass characteristics. The deviant minority can only be understood when seen in its societal context, and effective prevention requires changes which involve the population as a whole. He explores the options for prevention, considering them from various viewpoints - theoretical and scientific, sociological and political, practical and ethical. The applications of his ideas are illustrated by a variety of examples ranging from heart disease to alcoholism to road accidents. His pioneering work focused on a population wide approach to the prevention of common medical and behavioral disorders has become the classic text on the subject.
This reissue brings the original text to a new generation involved in preventive medicine. Kay-Tee Khaw and Michael Marmot retain the original text intact, but have added their own perspective on the work. They examine what relevance Rose's ideas might have in the era of the human genome project and other major scientific advances, they consider examples of how the theory might be applied and generalised in medicine and beyond, and discuss what implications it holds for the future. There is also an explanation of the population perspective, clarifying the oftenconfused thinking and arguments about determinants of individual cases and determinants of population incidence.
Rose's Strategy of Preventive Medicine will ensure that this seminal work continues to be read by future generations.

Health inequalities according to people's social standing are persisting, or even growing, in modern societies. Recent decades have revealed evidence of strong variations in life expectancy, both between countries and within them. This widening of social inequalities has developed despite considerable progress in medical science and an increase in health care spending. The reasons behind this are complex, and the implications considerable. This book provides a summary of the major achievements of a five-year European Science Foundation (ESF) Programme on 'Social Variations in Health Expectancy in Europe'. The contributors are major figures in their subjects, and combine state of the art reviews with the latest results from interdisciplinary research in epidemiology, sociology, psychology and biomedicine. Three conceptual frameworks of life course influences, health effects of stressful environments, and macro social determinants of health, are unified, while each chapter addresses the policy implications and recommendations derived from currently available evidence. The major topics covered include the role of family in early life, social integration and health, work stress and job security, successful ways of facing adversity, and the impact of the larger environment on health. Epidemiologists, public health research and policy makers, and students of related public health and sociology courses wlll find the results of this research fascinating.

Coronary heart disease is the leading cause of death worldwide affecting millions of people in both developed and developing countries. The dual aims of this book are to review the well-established and emerging risk factors in coronary heart disease and to apply this knowledge to public health approaches to disease prevention. The book includes authoritative accounts of studies within a single population and international studies, important areas of methodological development, trials to test preventive strategies, and the application of epidemiological and other knowledge to the development of public health policy for the prevention of widespread disease. It is an all-encompassing work containing contributions from the world authorities in the field. The book is divided into four sections. The introduction reviews advances in the understanding of, and the current status, of risk factors for CHD. Section 2 looks at recent global trends and emerging patterns of CHD morbidity and mortality in several countries, and includes chapters on work done under the auspices of WHO on the global burden of disease in relation to smoking and blood pressure. Section 3 focuses on advances in understanding the aetiology of CHD with each chapter focused on a particular risk factor. Section 4 explores measures of prevention and intervention in terms of public health policy with specific examples from around the world.

Social Determinants of Health, 2E gives an authoritative overview of the social and economic factors which are known to be the most powerful determinants of population health in modern societies. Written by acknowledged experts in each field, it provides accessible summaries of the scientific justification for isolating different aspects of social and economic life as the primary determinants of a population's health.
The new edition takes account of the most recent research and also includes additional chapters on ethnicity and health, sexual behaviors, the elderly, housing and neighborhoods.
Recognition of the power of socioeconomic factors as determinants of health came initially from research on health inequalities. This has led to a view of health as not simply about individual behavior or exposure to risk, but how the socially and economically structured way of life of a population shapes its health. Thus exercise and accidents as as much about a society's transport system as about individual decisions; and the nation's diet involves agriculture, food manufacture, retailing, and personal incomes as much as individual choice. But a major new element in the picture we have developed is the importance of the social, or psycho-social, environment to health. For example, health in the workplace for most employees - certainly for office workers - is less a matter of exposure to physical health hazards as of the social envrionment, of how supportive it is, whether people have control over their work, whether their jobs are secure. A similar picture emerges in other areas ranging from the health importance of the emotional envrionment in early childhood to the need for moresocially cohesive communities.
Social Determinants of Health, 2E should be read by those interested in the wellbeing of modern societies. It is a must for public health professionals, for health promotion specialists, and for people working in the many fields of public policy which we now know make such an important contribution to health.

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. This new evidence is compelling. It has the potential to change radically the way we think about health, and indeed society.

"Bold, important and masterful . . . Marmot's message is not just timely, it's urgent."
" -The Washington Post Book World"
You probably didn't realize that when you graduate from college you increase your lifespan, or that your co-worker who has a slightly better job is more likely to live a healthier life. In this groundbreaking book, epidemiologist Michael Marmot marshals evidence from nearly thirty years of research to demonstrate that status is not a footnote to the causes of ill health-it is the cause. He calls this effect the status syndrome.
The status syndrome is pervasive. It determines the chances that you will succumb to heart disease, stroke, cancers, infectious diseases, even suicide and homicide. And the issue, as Marmot shows, is not simply one of income or lifestyle. It is the psychological experience of inequality-how much control you have over your life and the opportunities you have for full social participation-that has a profound effect on your health.
"The Status Syndrome" will utterly change the way we think about health, society, and how we live our lives.