The above quote by Pablo Neruda is the opening line of the latest government policy document on health inequalities. We learnt yesterday of some of the findings of Lord Marmot, author of Fair Society, Healthy Lives, that where you live determines not only how long you live but also the quality of your life. Those in poorer areas are likely to die 7 years earlier than those living in more affluent areas, and also that those who die earlier are likely to have health problems leading up to that earlier death.
When I heard these findings I thought, did we not hear that from the Black Report of 1980, and again almost 20 years later when the Acheson enquiry report came out? Has anything changed?
What the Marmot review has done that is different is acknowledge that mistakes had been made in the implementation of previous policies in that they were too narrowly focused and not long term enough, that communication was an issue in implementing a national strategy.
So are we entering a new era with this new, more pragmatic style report, or are the obstacles that need to be overcome to make the society we live in more equitable?
Last year the government missed its target to halve childhood poverty by 2010, and with 3 million children living in poverty, it does suggest that the health and social inequalities that such poverty brings are setting up generations of health inequalities for the future.
I think the Marmot Review is a real step in the right direction to addressing health and social inequalities, however the real obstacles not really tackled will be the cost of such initiatives, and perhaps more pertinent even, is the long term political commitment to making ours a more equitable society, so that in another 30 years the next generation is not dealing with the same dilemmas.
“We are not tinkers who merely patch and mend what is broken… we must be watchmen, guardians of the life and the health of our generation, so that stronger and more able generations may come after”
Dr Elizabeth Blackwell (1821-1910), The First Woman Doctor