A noted epidemiologist demonstrates how social inequalities cause ill health and how opportunities for full social participation can mitigate the effects of the psychological experience of inequality.
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In this book, Michael Marmot, an internationally renowned epidemiologist, marshals evidence from around the world and from nearly thirty years of his own research to demonstrate the importance of status in our health, well-being, and longevity. For years we have focused merely on how advances in technology and genetics can extend our lives and cure disease. But, Marmot argues, we are looking at the issue backwards. In the past, we have viewed social inequalities as a footnote to the real causes of ill-health; in fact, they are a major cause. He calls this effect the "status syndrome."The status syndrome is pervasive. It determines the chances that you will succumb to heart disease, stroke, lung cancer, infectious diseases, even suicide and homicide. And the issue, as Marmot shows, is not simply one of income. Nor is it a case of differences in lifestyle - the likelihood that you are a smoker, or that you eat a high-cholesterol cheeseburger every day. It is the psychological experience of inequality - how much control you have over your life and the opportunities you have for full social participation - that has a profound effect on your health.For instance, by investing in early child development and the education system, we can give children a better chance of improving their status and thus their health as adults. By creating secure jobs that give employees some control over the way they manage their careers and reward them for their efforts, we can diminish the social inequalities and health risks of the workplace. By providing older people, and communities in general, with support systems that increase social contact, we can improve health as well. While these are not the usual routes to curing disease, Marmot shows that they are critical ones.
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