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That a lack of wealth all too often translates into poor health may seem pai

游客2024-03-09  46
问题     That a lack of wealth all too often translates into poor health may seem painfully obvious. But now a review of health inequalities in England reveals that such differences don’t just disadvantage the least well-off. The review also suggests some strategies to tackle the inequalities. These remedies should apply the world over, including in the US, where health and wealth inequalities can be especially obvious.
    Commissioned by the UK government, the review was headed by Michael Marmot of University College London, who most famously showed that British civil servants at the bottom of the organisational pile were much more likely to suffer heart disease than those at the very top. In his latest work, Marmot uses census data from across England to show that these health inequalities don’t just exist between the richest and the poorest.
    For example, even if you exclude the richest and poorest 5 per cent of people in England, the richest remainder can expect to live 6 years longer than the poorest, and enjoy an extra 13 years free of disability. Marmot says action to reduce health inequalities should take place right across society, not focus solely on the poor. "It’s not rich versus poor, because it’s a social gradient (坡度)," he says.
    What’s more, the most productive time to intervene to create a healthier society is childhood, Marmot says. That children who start out with well-off, well-educated parents are likely to be healthier would seem to be something of a no-brainer. But the fates of 17,200 UK babies monitored since they were born in the same week in April 1970, and highlighted in Marmot’s review, make compelling evidence.
    It turns out that babies who had low IQs at 22 months and were born to richer, better educated parents caught up by the age of 6 with children who started with high IQs but whose parents were poorer and less educated. By age 10, the children in the higher socio-economic group were forging ahead on intelligence tests while those in the lower socio-economic group fell further and further behind. "It shows that the social is beating the biological down," says Marmot. "We can change that, and that’s why I’m optimistic."
    He also finds that children in poorer families miss out on pre-school reading, socialising and physical exercise. This disadvantage leaves them trailing far behind when they start school and they seldom recover.
    Being behind can lead to behavioural and emotional problems. What’s more, the UK spends less on children during early childhood than at any other stage of their education.
    Therefore giving every child the best start in life "is critical in setting the foundation for a lifetime of health and successful contribution to society".
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