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In Baltimore's inner-city neighborhood of Upton/Druid Heights, a man's life expectancy is sixty-three; not far away, in the Greater Roland Park/Poplar neighborhood, life expectancy is eighty-three. The same twenty-year avoidable disparity exists in the Calton and Lenzie neighborhoods of Glasgow, and in other cities around the world.

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.
Social Determinants of Health, 2nd Edition 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 behaviours, the elderly, housing and neighbourhoods. 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 behaviour or exposure to risk, but how the socially and economically structured way of life of a population shapes its health. Thus exercise and accidents are 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 environment, 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 environment in early childhood to the need for more socially cohesive communities. Social Determinants of Health 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.
Based on decades of his own research, a pioneering epidemiologist reveals the surprising factors behind who lives longer and why

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.

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