This is another redoubtable interview by Margaret Throsby during her recent tour of Europe with the ACO (Australian Chamber Orchestra). Marmot holds a professorship at University College London and was President of the BMA (British Medical Association) until recently. As he admits in the interview, he was an unusual President in that he had an agenda.
The reason I’m writing a post about it is that he confirms a long-held belief of mine that the sense of having control of your life, or not, has an impact on your health, both psychological and physical. He quotes a German physician from the 19th Century, who apparently said: ‘physicians are the natural attorneys of the poor.’ This is because there is a ‘social gradient of health’ that exists in all Western societies (at least) and is not only unacknowledged but ignored. In other words, the poorer you are the poorer your health. According to Marmot, this gradient is statistically true right from the top to the bottom of our social hierarchy. And he puts it down to the sense of control one feels one has over one’s life. This outcome doesn’t surprise me, but apparently it surprises most other people, who think that the higher you are in the social train the more stress you are under and therefore the greater are your health risks. Marmot admits he thought this himself until he did the analysis and found the converse to be true.
Amongst other things, it makes a mockery of the health-reform debate in America, who seem determined to lag behind the rest of the Western world when it comes to social health issues.
In another interview by former Australian Prime Minister, Paul Keating, that touches on subjects like the lost opportunities at the end of the Cold War and politicians' propensity to not tell people the truth, he points out how real incomes in America have not increased over the last 20 years, which contributed to the subprime crisis. In America, corporations have a stranglehold on domestic politics, and no one sees the deleterious effect this has on the welfare of ordinary people.
This is a not unrelated side-issue to the fact that people, wherever they live, are deeply affected by living and working conditions that erode their sense of worth. We actually get the best out of people when they feel they have control over what they’re doing and are not just automatons. This means that the lower one is down the pecking order the less control one feels one has over one’s life and the greater the risk to their health and wellbeing. According to Marmot, figures from all over the Western world confirm this.
At the end of the interview he provides an interesting ‘statistic’. He contends that, globally, 100 billion people live in poverty and that 100 billion dollars could change that situation. This, of course, is a lot of money, but, to put it into perspective, 9 trillion dollars was spent to bail out the banks. It makes one wonder, when, and if, we will finally appreciate that promulgating the global poverty gap is not the way to proceed in the 21st Century.
P.S. I'm unsure how long these interviews are available.