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'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.
"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.
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.
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