Middle classes in ‘health injustice’
Global expert warns of death rate gap
MEDICAL: Social injustice is affecting the health of the middle classes and not just the most disadvantaged, a leading doctor warned. Sir Michael Marmot said the average person will live eight fewer healthy years than those at the top of society.
SOCIAL INJUSTICE in the UK is affecting the health of the middle classes and not just the most disadvantaged people in society, a leading doctor has warned.
Sir Michael Marmot, president of the World Medical Association, said the average person – who is neither at the top or bottom of the social spectrum – will live around eight fewer healthy years than those at the top of society.
The professor of epidemiology at University College London is lobbying for a move away from conventional approaches to improving healthcare, such as better access to health services, instead insisting that the Government must focus on the inequalities in living conditions throughout the whole social gradient to make a difference to the nation’s health. While the health of the nation is improving, the gap between the very poor and the very rich remains largely the same.
Addressing social factors, such as limited education and stressful working conditions, could save 202,000 “average” lives a year, he added.
He said: “It’s not the one per cent versus everybody else – it’s the higher you are the better your health.
“The way I want to change the conversation is instead of focusing on the bottom, let’s focus on the top and the middle.
“On average people are living about eight fewer years of healthy life. That doesn’t just mean dying sooner – that means earlier onset of disability, decline in grip strength, respiratory function, mobility, cognitive ability – all happen at an earlier age the lower down you are in the social hierarchy and that gradient runs all the way from the top to the bottom.
“If everybody in the country had the low mortality of the people with university education, we could prevent 202,000 premature deaths each year, before the age of 75.
“We do know what causes it – it’s inequality in the conditions in which people are born, grow, live, work and age and inequities in power, money and resources, that give rise to those inequities in conditions of daily life.
“People in the top have the best health and there is no good biological reason why people in the middle, regardless of where we are in the hierarchy, can’t enjoy the same good health as people at the top.
“We know what to do and we can do it – the fact that we’re not doing it is why I am talking about social injustice killing people on a grand scale.”
Sir Michael, also the Royal College of Physicians’s special advisor on health inequities, has published his research in his latest book, ‘The Health Gap’.
The most powerful factors affecting the average person’s health include early childhood, education, employment and working conditions and a suitable wage for a healthy lifestyle.
He argues that austerity policies and cuts to local government budgets – which have led to the closure of Sure Start centres and a lack of funding in some schools – has a direct effect on the health gap.
However, he added that income only had a relative impact on health, particularly in a society like the UK where everyone has access to free healthcare.
He repeated calls for the Government to look beyond the immediate situation to consider the social conditions which led to a patient or resident’s problem.
I am talking about social injustice killing people
on a grand scale. Sir Michael Marmot of the World Medical
Association