You probably didn't realize that when you graduated from college you increased your lifespan, or that your co-worker who has a master's degree is more likely to live a longer and healthier life. Seemingly small social differences in education, job title, income, even the size of your house or apartment have a profound impact on your health.
For years we have focused merely on how advances in technology and genetics can extend our lives and cure disease. But as Sir Michael Marmot argues, we are looking at the issue backwards. Social inequalities are not a footnote to the real causes of ill health in industrialized countries; they are the cause. The psychological experience of inequality, Marmot shows, has a profound effect on our lives. And while this may be alarming, it also suggests a ray of hope. If we can understand these social inequalities, we can also mitigate their effects.
In this groundbreaking book, Marmot, an internationally renowned epidemiologist, marshals evidence from around the world and from nearly thirty years of his research to demonstrate that how much control you have over your life and the opportunities you have for full social participation are crucial for health, well-being, and longevity. Just as Bowling Alone changed the way we think about community in America, The Status Syndrome will change the way we think about our society and how we live our lives.
In Sierra Leone, one in 21 fifteen-year-old women will die in her fertile years of a maternal-related cause; in Italy, the figure is one in 17,100; but in the United States, which spends more on healthcare than any other country in the world, it is one in 1,800 (and now, with the new administration chipping away at Obamacare, the statistics stand to grow even more devastating). Why?
Dramatic differences in health are not a simple matter of rich and poor; poverty alone doesn't drive ill health, but inequality does. Indeed, suicide, heart disease, lung disease, obesity, and diabetes, for example, are all linked to social disadvantage. In every country, people at relative social disadvantage suffer health disadvantage and shorter lives. Within countries, the higher the social status of individuals, the better their health. These health inequalities defy the usual explanations. Conventional approaches to improving health have emphasized access to technical solutions and changes in the behavior of individuals, but these methods only go so far. What really makes a difference is creating the conditions for people to have control over their lives, to have the power to live as they want. Empowerment is the key to reducing health inequality and thereby improving the health of everyone. Marmot emphasizes that the rate of illness of a society as a whole determines how well it functions; the greater the health inequity, the greater the dysfunction.
Marmot underscores that we have the tools and resources materially to improve levels of health for individuals and societies around the world, and that to not do so would be a form of injustice. Citing powerful examples and startling statistics (“young men in the U.S. have less chance of surviving to sixty than young men in forty-nine other countries”), The Health Gap presents compelling evidence for a radical change in the way we think about health and indeed society, and inspires us to address the societal imbalances in power, money, and resources that work against health equity.