HEALTH: Distribution of Wealth and Power Is Central to a Nation's Health; THE PROFESSIONALS

Western Mail (Cardiff, Wales), October 6, 2008 | Go to article overview

HEALTH: Distribution of Wealth and Power Is Central to a Nation's Health; THE PROFESSIONALS


Byline: Paul Walker

AS IS my custom in early September I made my annual pilgrimage to France - this time to the north coast of Brittany.

As always I was struck by the cleanness, the sense of order and the general air of comfort and material wealth.

This contrasts markedly with my first impression of the country when I visited on a school-organised exchange in 1954.

To a 13-year-old from the North of England, the country looked run down and the people looked poor.

Now everyone looks as if they have money in the bank, or even under the bed, and enough to spare for luxuries - and this includes the elderly.

France is an innately rich country. But part of its formula for the good life is its adoption of the so-called Rhenish or social model of capitalism, which facilitates the redistribution of wealth through the social security system to the poor, the unemployed and the retired.

In the global league table of wealth distribution, France fares rather better than the UK and the other so-called Anglo-Saxon economies, which have adopted a more market-driven model.

The gini coefficient - a measure of income inequality where the higher the score the more unequal the distribution - for France in 2005 was 28 compared with 34 for the UK.

The implications of this difference in approach made a particular impression this year, because in the course of my holiday the World Health Organisation published the final report of its Commission on the Social Determinants of Health.

The degrees of health inequity catalogued in the report are truly staggering - a woman born in Botswana can anticipate living an average of 43 years, exactly half the longevity of the average Japanese woman.

Nearer home, men in the poorest parts of Glasgow have a life expectancy of 54 years compared to 82 years - 50% longer - in the most affluent suburbs.

The commission suggests three lines of action to combat these inequities:

First, improving the conditions of daily life, including healthy environments and housing, fair employment and decent work plus universal healthcare.

Secondly, reducing the inequitable distribution of power, money and resources globally, nationally and locally through, for example, evaluating all policies and programmes for health equity, and through political empowerment of the people;

And thirdly, taking steps to measure and monitor the extent of health inequities, training public health workers and others in the impact of the social determinants and raising public awareness of these. …

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