Friday, September 07, 2007

Hierarchy of Power and Long Life

Life expectancy in the richest countries of the world now exceeds the poorest by more than 30 years, figures show .

Average life expectancy in Britain and similar countries of the OECD was 78.8 in 2000-05, an increase of more than seven years since 1970-75 and almost 30 years over the past century.

In sub-Saharan Africa, life expectancy has increased by just four months since 1970, to 46.1 years.

Narrowing this "health gap" will involve going beyond the immediate causes of disease – poverty, poor sanitation and infection – to tackle the "causes of the causes" – the social hierarchies in which people live, the Global Commission on the Social Determinants of Health says in a report.

Even in the UK the privileged live longer . In the 1980s, in a series of ground-breaking studies among Whitehall civil servants showed that the risk of death among those on the lower rungs of the career ladder was four times higher than those at the top, and that the difference was linked with the degree of control the individuals had over their lives.

Professor Sir Michael Marmot, chairman of the Global Commission on the Social Determinants of Health stated that if people increased their status and gained more control over their lives they improved their health because they were less vulnerable to the economic and environmental threats.

The result is that even within rich countries such as Britain there are striking inequalities in life expectancy. The poorest men in Glasgow have a life expectancy of 54, lower than the average in India. Infant mortality is still twice as high among the poor in Britain, 7 per 1,000 among the poor and 3.5 among the rich .

The answer, the report says, is empowerment, of individuals, communities and whole countries.

"Technical and medical solutions such as medical care are without doubt necessary. But they are insufficient." Professor Marmot said: "We talk about three kinds of empowerment. If people don't have the material necessities – food to eat, clothes for their children – they cannot be empowered. The second kind is psycho-social empowerment: more control over their lives. The third is political empowerment: having a voice."

The simple fact of the matter is that solutions will not be found inside the capitalism whatever may be claimed by the welfare reformers . The present system relies on a small minority maintaining control and authority over the majority and artificially rationing the means of life .

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