We have to put reduction of health inequalities at the centre of our public health strategy and that will require action on the social determinants of health. Michael Marmot More Quotes by Michael Marmot More Quotes From Michael Marmot Health inequalities and the social determinants of health are not a footnote to the determinants of health. They are the main issue. Michael Marmot inequality issues social Empowerment of individuals and communities is absolutely central. Getting the community involved in organising their own destiny has got to be a key part of it. Michael Marmot destiny community keys The lower you are in the hierarchy the worse your health, the higher you are, the better your health. Michael Marmot hierarchy higher There's good evidence that if people are disempowered, if they have little control over their lives, if they're socially isolated or unable to participate fully in society, then there are biological effects. Michael Marmot evidence littles people Low income is related to poorer housing, poorer diet, fewer social amenities, worse working conditions. (...) After adjustment for age, sex, race, smoking, alcohol consumption, sleep habits, leisure-time physical activity, chest pain, diabetes, or cancer, there was still an increase risk of 1.6 for those with inadequate incomes. Michael Marmot cancer pain sex For every dollar spent on early child development you save $7 over the life course because children with better early child development are less likely to end up delinquent, involved in crime, unemployed and so on. Michael Marmot dollars development children I don't blame people for smoking when I see a social gradient in smoking. I say we need to understand why is it the lower you are in the hierarchy the more likely you are to smoke. So we need to address the causes of the causes. Michael Marmot smoking people needs Health and health inequalities tell us a great deal about the good or bad effects of social policies. Michael Marmot inequality deals social Throwing young people on the scrap heap is a public health emergency. Michael Marmot emergencies throwing people Your position in the hierarchy influences your behaviour. Michael Marmot hierarchy influence behaviour ... social environment in childhood affects achieved adult height, life chances, and ultimately mortality rates in adult life. (...) ... social circumstances acting in childhood do have a persisting effect on adult disease rates, in addition to influences acting in adulthood. Michael Marmot childhood health acting Australia is a very healthy country which goes along with the fact that it's very high on the Human Development Index, high wealth, good levels of education. So Australia ranks right up there, second or third on the Human Development Index. And Indigenous Australians, if you treated them as if they were a separate country, would rank probably about 100th or below 100. Michael Marmot australia healthy country Once you get off the ladder you'll never get back on. Michael Marmot get-back ladders General improvements in health/decline in mortality do not affect all classes equally. As mortality rates fall, social inequalities commonly widen. Michael Marmot health class fall Saying we can't afford to invest in early child development means we're storing up bigger costs in the future. Michael Marmot cost mean children Our elected politicians do what they judge is the right thing to do. And if we disagree then I'll show them the evidence of why I disagree. Michael Marmot evidence politician judging It's not just that people with no education have worse health. People with a bit of education at somewhat better, with a lot of education it's even better. And with even more education it's better still. Michael Marmot bits stills people The brain is an important gateway by which the social environment impacts on people's health through the mind. Michael Marmot impact brain people Angus Deaton has written a wonderful book, The Great Escape: Health, Wealth, and the Origins of Inequality. . . . Deaton's book is a magisterial overview of health, income, and wealth from the industrial revolution to the present, taking in countries poor and rich. Not just jargon-free but equation-free, the book is written with a beautifully lucid style. . . . [P]owerfully argued and convincing. Michael Marmot style country book The differences between Indigenous and not Indigenous Australians can be easily attributed not to differences in their genes but to differences in the conditions in which they're born, grow, live, work and age - in other words, to the social determinants of health. Michael Marmot differences social age
