Guess what it is this time. Smoking? Alcohol? Diet? Nope, none of them. It’s unemployed youth:
Young people who are not in employment or education in Britain are “a public health time bomb waiting to explode,” the World Health Organisation has said.
‘Neets’ – or young people not in employment, education or training – were likely to have worse health than their employed counterparts and the Government needed to act to ensure health inequality does not become entrenched, the authors of a report by the organisation claimed.
No doubt buoyed by their successes with tobacco, alcohol, and diet, public health zealots are now moving into overtly political territory.
“Unemployment may be falling in the UK, but persistent high levels of the number of young people over 18 not in employment, education or training is storing up a public health time bomb waiting to explode,” said Professor Sir Michael Marmont, who chaired the study.
Unemployment is now a public health concern.
“Health inequality, arising from social and economic inequalities, are socially unjust, unnecessary and avoidable, and it offends against the human right to health.”
Wealth inequality = health inequality. Or wealth = health. A debate about social justice that used to be conducted in the political arena has been transferred to the public health arena. Politics has been medicalised. Or, same thing, medicine has been politicised.
And you now have a right to be
wealthy healthy. Did you know that? And if somebody else is wealthier healthier than you are, it’s not fair.
Who’s Sir Michael Marmo
nt? He seems to be another one of those doctors who never actually practised medicine in any meaningful way.
Michael Marmot was born in London, England. He moved to Australia as a young child, attending Sydney Boys High School (1957-1961) and graduated in medicine from the University of Sydney in 1968. He earned a MPH in 1972 and PhD in 1975 from the University of California, Berkeley.
Marmot became Fellow of the (English) Faculty of Public Health Medicine in 1989 and was appointed Professor of Epidemiology and Public Health at UCL in 1985. This became a joint Chair, held at UCL and the London School of Hygiene and Tropical Medicine, in 1990. He became Director of the International Centre for Health and Society (now the International Institute for Society and Health) that he established at UCL in 1994. He was a member of the Royal Commission on Environmental Pollution and awarded an MRC Professorship in 1995. He was elected as a Fellow of the Royal College of Physicians in 1996. In 2004 he was awarded the Balzan Prize for Epidemiology. He was Chair of the WHO Commission on Social Determinants of Health from 2005 to 2008.
I wonder what his views are on the exclusion and demonisation of smokers ?
In The Status Syndrome: How your social standing directly affects your health and life expectancy, he argues that socio-economic position is an important determinant for health outcomes. This result holds even if we control for the effects of income, education and risk factors (such as smoking) on health. The causal pathway Marmot identifies concerns the psychic benefits of “being in control” of one’s life. Autonomy in this sense is related to our socio-economic position. Based on comparative studies, Marmot argues that we can make our society more participatory and inclusive in order to increase overall public health.
So excluded and demonised smokers can be expected to now enjoy, as second or third class citizens, even worse health than they did before. And indeed they do. But no doubt any decline in their health will be blamed on their smoking habits rather than social exclusion.
Is there anything that is outside the remit of Public Health? I can’t think of anything which doesn’t have health consequences of one sort other. So why not just close down all the other government ministries, and replace them all with a single Department of Health?