The report from a World Health Organisation commission headed by a British professor, Sir Michael Marmot, says a toxic combination of bad policies, economics and politics is in large measure responsible for the majority of the world’s people not enjoying the good health that is biologically possible.
The consequences of social injustice are most marked in developing countries, where the poorest struggle even to survive. Average life expectancy in some African countries is below 50 years. But the underlying issues are similar all over the world.
“In rich countries, low socioeconomic position means poor education, lack of amenities, unemployment and job insecurity, poor working conditions and unsafe neighbourhoods, with their consequent impact on family life. These all apply to the socially disadvantaged in low-income countries in addition to the considerable burden of material deprivation and vulnerability to natural disasters,” the report says.
Rapid change is possible, it says. Greece and Portugal had child mortality of 50 per 1,000 40 years ago. Now they are not far behind Iceland, Japan and Sweden, which have the longest life spans in the world. In the same period, Egypt has gone from 235 to 35 per 1,000.
But change in the other direction can be equally rapid. Adult mortality in the Russian Federation since the political, social and economic upheaval of 1992 has risen.
The commission wants every government policy and programme to be assessed for its impact on health. Above all, it says, governments should invest in high quality education with a focus on intervening in the earliest years, from womb to age eight. — © Guardian Newspapers Limited, 2008
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