The Health Gap: The Challenge of an Unequal World

It's no surprise that social and economic inequalities create poor health.  Including obesity. Is there a solution?  None, according to the author, until Government policy targets the sources: education, social mobility and poverty. 

The Health Gap: The Challenge of an Unequal World Author - Michael Marmot

Professor Sir Michael Marmot is Professor of Epidemiology at University College London, Director of the UCL Institute of Health Equity, and past President of the World Medical Association.
For 40 years he has led research into health inequalities and is perhaps best known for his 2010 Strategic Review of Health Inequalities in England.

Review by Jeryl Scurr

Social injustice is bad for our health. In this book Marmot clearly explains the disastrous effect this has on the health of nations. And the weight of our nation.

His message is that inequality in power, money and resources leads to poor quality of life, driving up levels of bad health and obesity.

Hard facts show how the gap between the best and worse off in society grows ever larger.

Hard facts. Hard to read.

In The Health Gap Marmot describes the social determinants of health as “the conditions in which people are born, grow, live, work and age. “

The poorer those conditions the more likely you are to be jobless, badly employed, engage in unhealthy behaviours and suffer from poor mental health.

In 2019, Ben Humberstone, the ONS deputy director for Health Analysis and Life Events stated that analysis of mortality had shown that life expectancy in the UK had stopped improving at the rate expected.

Shockingly, this is directly attributable to what Marmot calls ‘the health gap.’

Poor access to food, hunger, lack of education and inadequate help from government are the main contributors.

This gap – between the worst off and the best off in society – is blamed for the difference in life expectancy in the UK in the last few years up to 9.4 years. Women, unsurprisingly, are the worst affected. (So, what is new?)

If the year was 1820 one might expect to read this – but in 2020?

It’s not all doom and gloom, however. Marmot’s solutions to bridge the gap are practical, realistic, and achievable:

“We can reduce avoidable inequalities in health, starting with equity in early child development, education, working conditions and better conditions for older people…I show (in The Health Gap) we can make a difference.”

An articulate writer and eloquent speaker, I enjoyed seeing him interviewed on this book – I highly recommend you look him up on YouTube.


“The ill health of the poor can excite prejudice: e.g., the poor are the architects of their own misfortune; worrying about them only encourages fecklessness.”

“A social environment that is discriminatory… will do little for social integration. Given all of this, healthy lifestyle choices are low priority.”

Why I chose The Health Gap

I chose this book as a long time believer that economic and social inequalities help fuel the obesity epidemic. Government needs to acknowledge, as Marmot points out, that the solution has always been within their hands.

We must not let Clovid-19’s financial impact keep us in 1819…

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