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From The Socialist newspaper, 5 October 2016

Non-fiction: Health Divides

Review: where you live can kill you

NHS workers marching in Manchester, 4.10.15, photo Sarah Wrack

NHS workers marching in Manchester, 4.10.15, photo Sarah Wrack   (Click to enlarge)

ZoŽ Brunswick

Clare Bambra provides a good, easy-to-understand introduction to the major causes of health inequality in rich countries.

The opening chapters introduce the concept of 'health divides' - not only across regions, but often within neighbourhoods. One shocking example is Stockton-on-Tees, where life expectancy varies by 17 years between rich and poor parts of the town.

Bambra goes on to explain the multifaceted causes of health inequalities. Denouncing the claim that poor health is due to poor personal choice, she suggests instead it is a mixture of lifestyle and area that contributes to health inequalities.

Poverty is identified as one of the most pertinent determinants of health. It is strongly linked to unemployment, poor education, poor diet and lack of good housing. Bambra also explores how the rapid deindustrialisation of the north of England and parts of Scotland has led to a certain north-south divide in health.

Political choice

Using the metaphor of a river, Bambra explains that ultimately it is political choices that are the "upstream" cause of health inequality. Political choices to spend less money in working class areas have led to poor education, poor housing, unemployment and the misery and despair those things cause. All this has contributed to health-damaging behaviours such as smoking and excessive drinking.

The book concludes by discussing recommendations from past reports on health inequality, including the Black report and the Marmot report. These identified many of the health issues stemming from unemployment, poor housing and poverty - but governments ignored their recommendations.

Bambra suggests this is due to the neoliberal idea that health is an individual issue. Wider determinants of health are therefore ignored.

While the book explores in-depth the causes behind health inequalities, correctly identifying politics as the root cause, it does relatively little to explain what is needed to resolve it. For example, while commending recommendations such as "building more high quality social housing", the book does not explore in much depth why it is that these policies were not put into practice, and why such large health divides still exist today.

The recommendations in the concluding chapter could also go much further. Bambra suggests we must lobby MPs, and vote in a government that will put through better health policy.

Of course, pressuring political representatives, and campaigning for a pro-working class health policy on the electoral plane, are important parts of any health strategy. But on their own they are not enough to tackle the shocking health inequalities highlighted in the book.

To really overcome health divides, it is necessary to build a mass movement to fight against austerity and for sweeping improvements to reduce inequality. A £10 an hour minimum wage without exemptions, and living benefits for those out of work. A mass programme of public works to create jobs and services. Free education. A fully funded, publicly owned NHS. And high-quality, genuinely affordable housing for all.

Essential reforms like this will not willingly be granted by the capitalist establishment, but need to be fought for and won by the organised working class. Only then will we see a true reduction in health inequalities.

And ultimately, the only way to make such reforms permanent is to transform society. That means fighting for a publicly owned, democratically controlled economy, with a socialist plan of production to meet the needs of all, rather than enriching a tiny minority.

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In The Socialist 5 October 2016:


What we think

Combative, vibrant unions should be central to the Corbyn movement


Socialist Party news and analysis

Tories out!

Come to Socialism 2016!

Sam Allardyce corruption shame: reclaim the game!

Asos workers fear taking toilet breaks, sacked for panic attacks

UK workers born in early 1980s half as wealthy as those born in 1970s

Millions have less than £100 savings

Them & Us

What we saw


Black History Month

Fighting racism today


Workplace news and analysis

RMT president Sean Hoyle speaks to the Socialist

Durham teaching assistants ballot for strike

Napo conference 2016: new mood of determination

London Met strike against job cuts and victimisation

Workplace news in brief


Socialist readers' comments and reviews

Corbyn's praise for Cardiff Labour is mistaken

Review: where you live can kill you

Review: international jazz protest storytelling

The Socialist inbox


Socialist Students

Socialist ideas - winning a new generation of students


Socialist Party reports and campaigns

Thousands march against Tory conference

Protests against children's centre closures in Bolton

Why I joined the Socialist Party

Fighting fund record smashed again!

Leeds: Solidarity demo with Irish abortion fight

London: Socialism Today milestone celebration

Worcester: Public meeting discusses Corbyn


International socialist news and analysis

Poland: Fighting back against anti-abortion law

Ireland: repeal the 8th Amendment!

Joint declaration by Izquierda Revolucionaria and the CWI


 

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