What good does it do to treat people and then send them back to the conditions that made them sick?
This is the key question and resulting problem posed by the Director of the Institute of Health Equity in the Department of Epidemiology and Public Health at University College in London, Sir Michael Marmot, who spoke at UKZN.
Marmot, the immediate past-president of the World Medical Association, delivered a public lecture hosted by UKZN’s School of Nursing and Public Health and the South African Medical Association (SAMA). The theme was: “Social Determinants of Health”.
He is the author of: The Health Gap: the Challenge of an Unequal World (Bloomsbury: 2015) and: Status Syndrome: How Your Place on the Social Gradient Directly Affects your Health (Bloomsbury: 2004). He has been awarded honorary doctorates from 17 universities and is a member of the National Academy of Medicine and has authored more than 1 100 scientific publications.
In 2000 he was knighted by Queen Elizabeth of England, for services to epidemiology and the understanding of health inequities.
While in Durban he spent a morning visiting and addressing healthcare workers at public sector hospitals and clinics before his talk to UKZN academics and students as well as members of the public during which he provided evidence from studies done in high and low income countries on the effect of social factors on health outcomes.
He emphasised that addressing these social determinants was even more relevant in today’s world and focused on the effect the factors had on both physical and mental health.
His input in the field of health inequities has been acknowledged by the World Health Organization in a document titled: “Closing the Gap in a Generation, the key aspects of which are social justice; material, psychosocial and political empowerment, and creating the conditions for people to have control of their lives”.
UKZN’s Family Medicine Specialist and KZN SAMA Chair, Dr Mergan Naidoo, said, ‘These aspects are especially important in the South African context as we are considered to be one of the most unequal societies in the world.’
In his address, Marmot said the Institute of Health Equity in London had the following six objectives in their work towards helping create health fair societies:
1. Give every child the best start in life.
2. Enable all children, young people and adults to maximise their capabilities and have control over their lives.
3. Create fair employment and good work for all.
4. Ensure a healthy standard of living for all.
5. Create and develop healthy and sustainable places and communities.
6. Strengthen the role and impact of ill health prevention.
Marmot provided evidence that focusing on early childhood development (pre-school) resulted in better school performance and thus easier access to tertiary education and ultimately, employment.
Naidoo said Marmot was a humble and sincere man with a mission to create awareness and provide the impetus for South Africans to seek local solutions for the many issues that plaque the country.
‘The challenge is for us as individuals living in an unequal society to heed his advice and take the appropriate steps to address the problems.’