Longer Life Is Born of Social Justice as Well as Health; Professor Gareth Williams of the School of Social Sciences at Cardiff University Makes the Case That Social Justice Is Good for Our Health the Thursday Essay
Byline: Professor Gareth Williams
With all the talk of credit crunch, boom and bust, home repossessions and rising fuel costs, a report published at the end of August which tells us at least as much about the state of our economy and society may have passed almost unnoticed.
The UN report, produced by a World Health Organisation commission, shows in stark terms the inequalities in health and life expectancy found across the world, and within different countries.
Closing the Gap in a Generation, by the intimidating entitled Commission on the Social Determinants of Health, chaired by a British professor, Sir Michael Marmot, has a global reach - but it is also uncomfortably close to home. In as much as health inequalities are avoidable, the report argues, the conclusion is unavoidable: "Social injustice is killing people on a grand scale."
The report has taken evidence from a wide range of sources. We all know that children have dramatically different life chances and life expectancy depending on where they are born. A girl born in Japan or Sweden can expect to live to more than 80 years, and remain in reasonably good health for most of her life. At the other extreme, in several African counbuild tries a girl born to day can expect to live less than 45 years, with many of these years being lived in chronic ill-health. And on this scale the UK comes out not too badly, with a life expectancy of 77 years for men and 81 years for women, and a National Health Service, free at the point of use, to look after us when things fall apart.
So, what has this got to do with us? Well, the stark reality is that in the UK, as elsewhere, things fall apart sooner for some people than for others. In all countries, wealthy or poor, there is a "health gap" between those who are better off and those who are worse off. In the UK the health gap is very wide, and getting wider, even after 11 years of Labour Government in Westminster.
To take the most dramatic example, in Scotland, a boy born in the suburb of Calton, east of Glasgow city centre, can expect to live 28 years less than one born in Lenzie a few miles away in East Dunbartonshire - less, too, than boys born in parts of India.
While this precipitous comparison has dominated the media reports, there are significant inequalities elsewhere, including Wales: life expectancy of 72 years in Bute town and Tredegar, for example, compared to 82 in Cyn
Cyncoed and 83 in Usk. For men, whose life expectancy is lower than that of women, there are a number of localities in both the north-east and South Wales (Shotton and Twyn Carno, for example) where life expectancy shamefully falls below 70 years.
While health inequality is not just a problem of poor countries, neither is it simply a problem for poor people in rich countries.
Health and illness follow a "social gradient": health gets progressively worse at each step down the social ladder. In other words, health inequalities tell us something about the whole of our society, not just those at the bottom of the heap.
This is important, because there is a tendency to respond to the bad news in a report such as this by blaming the victims portrayed in the news - those people living in "the Calton" or "the Gurnos" or, indeed, any other housing estate which can be safely defined by all sober and hard-working people as "somewhere else". …