Podcasts about sir michael marmot

Why do poor people in the South live longer than Northerners in similar deprivation? How do we fix health inequality? What can businesses do to help? Steph is joined by Sir Michael Marmot, professor of Epidemiology, to discuss why all policy decisions need to focus on health equity. Sign up to our newsletter to get more stories from the world of business and finance. Email: restismoney@gmail.com X: @TheRestIsMoney Instagram: @TheRestIsMoney TikTok: @RestIsMoney goalhangerpodcasts.com Visit: monzo.com/therestismoney Assistant Producer: India Dunkley Producer: Ross Buchanan Head of Content: Tom Whiter Exec Producers: Tony Pastor + Jack Davenport Learn more about your ad choices. Visit podcastchoices.com/adchoices

ALTENPFLEGE Messe | 08. – 10. April 2025 MesseNürnbergSpart mit dem Rabattcode APF25UEBERGABE 50 % auf das Dauerticket und sichert euch den vergünstigten Eintritt zu allen drei Messetagen!Zum Ticketshop: www.altenpflege-messe.de/besuchen.Der Gutscheincode ist ausschließlich für das Dauerticket gültig und kann nicht auf andere Ticketarten angewendet werden.Weitere Informationen zur Messe findet Ihr unter www.altenpflege-messe.de oder folgt den Social-Media-Kanälen @ALTENPFLEGEMESSE. #ALTENPFLEGE #whoCARESme---In dieser Folge sprechen wir mit Bianca Flachenecker über Health Equity/Gesundheitsgerechtigkeit. Ihr erfahrt mehr über die Einflussfaktoren und Hintergründe von Ungleichheit in der Gesundheitsversorgung, welche Auswirkungen bestehen können und was das Ganze mit Digitalisierung zu tun hat. Außerdem sprechen wir über die Rolle der Pflegefachpersonen in diesem Zusammenhang. Viel Spaß beim Lauschen. ShownotesBuch von Bianca Flachenecker (2024): Health Equity im deutschen Gesundheitssystem. Eine Studie zum ökonomischen Potenzial im Kontext der Digitalisierung. LinkedIn Kontakt von Bianca Somatoforme Störungen und Funktionsstörungen German Index of Socioeconomic Deprivation (GISD)Sozioökonomische Muster von Krebserkrankungen in DeutschlandSozioökonomische Ungleichheit und COVID-19 – Eine Übersicht über den internationalen Forschungsstand des RKI (2020)Gesundheitswirtschaftliche Gesamtrechnung (GGR)Krankheitslast und sozioökonomische Auswirkungen von Migräne in DeutschlandBuch von Christian Thielscher (2022): Wirtschaft und Gerechtigkeit. Was ist gerecht und wie beeinflussen Wirtschaftstheorien die Verteilung von Gütern?‘Nursing staff play an important role in building a fairer society' - Interviews des RCN mit Michael MarmotMichael Marmot (2017): The Health Gap: The Challenge of an Unequal World: the argument Das Gespräch mit Sir Michael Marmot, Präsident des Weltärztebundes: „Ärzte sind die Anwälte der Armen“In eigener SacheJetzt Übergabe Mitglied werdenWerde Teil der Übergabe-CommunityÜbergabe bei InstagramPflegeupdate hören

Watch the Q&A session here:  https://youtu.be/leCxdECjyDMReducing health inequalities is a matter of social justice. Strategies must address the social gradient in health, and efforts should extend beyond healthcare to address the conditions in which people are born, grow, live, work, and age. This lecture argues economic circumstances, while important, are not the sole drivers of health inequalities, and closing the health gap will take evidence-based action across the whole of society.This lecture was recorded by Michael Marmot  on 6th November 2024 at Barnard's Inn Hall, London.Sir Michael Marmot has been Professor of Epidemiology at University College London since 1985, and is Director of the UCL Institute of Health Equity. He served as President of the British Medical Association (BMA) in 2010-2011, and as President of the World Medical Association in 2015.  He is President of the Asthma + Lung UK.  He is a Fellow of the Academy of Medical Sciences and Honorary Fellow of the American College of Epidemiology and of the Faculty of Public Health; an Honorary Fellow of the British Academy; and of the Royal Colleges of Obstetrics and Gynaecology, Psychiatry, Paediatrics and Child Health, and General Practitioners.The transcript of the lecture is available from the Gresham College website: https://www.gresham.ac.uk/watch-now/health-gapGresham College has offered free public lectures for over 400 years, thanks to the generosity of our supporters. There are currently over 2,500 lectures free to access. We believe that everyone should have the opportunity to learn from some of the greatest minds. To support Gresham's mission, please consider making a donation: https://gresham.ac.uk/support/Website:  https://gresham.ac.ukTwitter:  https://twitter.com/greshamcollegeFacebook: https://facebook.com/greshamcollegeInstagram: https://instagram.com/greshamcollegeSupport the show

“If health has stopped improving it is a sign that society has stopped improving.”These are the words of Professor Sir Michael Marmot in the report Health Equity in England: The Marmot Review 10 Years on.In this special episode of Let's Talk Social Work, made to celebrate World Social Work Day 2024, Andy McClenaghan and guests, Sir Michael Marmot and Dr Ruth Allen, explore how poverty, inequality and social disadvantage impact health outcomes, life expectancy and quality of life. Sir Michael is a world-renowned expert on public health, Director of the Institute for Health Equity and author of The Health Gap: the challenge of an unequal world, and Status Syndrome: how your place on the social gradient directly affects your health. Ruth is the Chief Executive of the British Association of Social Workers. Ruth has had a long career in the field of mental health social work and prior to joining BASW was Director of Social Work at South West London & St Georges' Mental Health NHS Trust.Although poverty is an issue that has been discussed a number of times on the podcast, as so many of the problems which social workers support people to address are rooted in or exacerbated by poverty, we haven't previously looked at the social determinants of health and the extent to which inequality affects health outcomes. There are no guests better placed to discuss the social determinants of health and their relevance to social work policy and practice. Hosted on Acast. See acast.com/privacy for more information.

Welcome to the podcast where we will delve into the world of politics in the run up to the UK General Election. In today's episode, we have a special guest, Dr. Pallavi Devulapalli, a Green Party councillor and spokesperson on health. With a background in medicine, environmental activism and a passion for making a positive change, Pallavi shares her motivations for entering the political arena and her determination to be a part of the solution. We discuss the challenges of the current political landscape, including corruption and the need for better representation. Pallavi highlights the Green Party's unique advantage of not being influenced by big business, allowing them to focus on science, ethics, and compassion. We also explore the party's approach to cutting crime, addressing the wider determinants of health, and their stance on immigration. Join us as we uncover the underlying philosophy of the Green Party and how their commitment to the environment shapes their policies across various areas. Get ready for an insightful and thought-provoking conversation with Dr. Pallavi Devulapalli   The Green Party believes that addressing the wider determinants of health, such as poverty and lack of opportunities, will help reduce crime. They advocate for making drugs available through controlled regulation to improve safety and reduce crime. The Green Party's policies are interconnected, with links between health, transport, defense, peace, and security. They aim to reduce inequalities in population health and draw on the work of Sir Michael Marmot. The Green Party opposes MPs having investments in private healthcare and believes in the interconnectedness of mental and physical health. Their underlying philosophy is based on compassion and helping all living creatures on the planet. They advocate for a public national health service and increased funding to restore and sustain it. 8. The Green Party welcomes refugees and opposes dehumanizing language and rhetoric surrounding them. They believe in speaking up and gaining power to implement their policies, even if it means challenging the two major parties. Pallavi finds nourishment and optimism through practicing yoga and finding joy in her work as a GP and in politics.

Welcome to the podcast where we will delve into the world of politics in the run up to the UK General Election. In today's episode, we have a special guest, Dr. Pallavi Devulapalli, a Green Party councillor and spokesperson on health. With a background in medicine, environmental activism and a passion for making a positive change, Pallavi shares her motivations for entering the political arena and her determination to be a part of the solution. We discuss the challenges of the current political landscape, including corruption and the need for better representation. Pallavi highlights the Green Party's unique advantage of not being influenced by big business, allowing them to focus on science, ethics, and compassion. We also explore the party's approach to cutting crime, addressing the wider determinants of health, and their stance on immigration. Join us as we uncover the underlying philosophy of the Green Party and how their commitment to the environment shapes their policies across various areas. Get ready for an insightful and thought-provoking conversation with Dr. Pallavi Devulapalli   The Green Party believes that addressing the wider determinants of health, such as poverty and lack of opportunities, will help reduce crime. They advocate for making drugs available through controlled regulation to improve safety and reduce crime. The Green Party's policies are interconnected, with links between health, transport, defense, peace, and security. They aim to reduce inequalities in population health and draw on the work of Sir Michael Marmot. The Green Party opposes MPs having investments in private healthcare and believes in the interconnectedness of mental and physical health. Their underlying philosophy is based on compassion and helping all living creatures on the planet. They advocate for a public national health service and increased funding to restore and sustain it. 8. The Green Party welcomes refugees and opposes dehumanizing language and rhetoric surrounding them. They believe in speaking up and gaining power to implement their policies, even if it means challenging the two major parties. Pallavi finds nourishment and optimism through practicing yoga and finding joy in her work as a GP and in politics.

This time – shocking new evidence that austerity kills, featuring Professor Sir Michael Marmot, who leads the Institute for Health Equity at University College, London. Tough constraints on public spending were imposed by the coalition government in 2010 in the wake of the banking crisis, and continued for the rest of the decade.The IHE found that between 2011 and 2019 more than a million people in England had shorter lives than those who lived in the most affluent areas; and fewer years of healthy living.Around 148,000 of the excess fatalities appear to have been 'additional' deaths linked to austerity.Produced in Birmingham by Adrian Goldberg and Harvey White. Funded by subscriptions to the Byline Times. Made by We Bring Audio for Byline Times. Hosted on Acast. See acast.com/privacy for more information.

In this CPD eLearning podcast, produced in partnership with NHS England (formerly Health Education England), CPD eLearning Podcast Editor Dr Nadia Imran, Professor Sir Michael Marmot and RCPsych Equality Champion Dr Amrit Sachar address the factors that cause and perpetuate health inequities and inequalities.

There's a definite fin de siècle feel about Westminster these days reminiscent of the last days of the Major government in 1997.The Prime Minister, who last weekend got all tough over Johnson's honours nominations, bottled the debate and vote on the Privileges Committee report, as did another 285 of his MPs. It duly passed but revealed the weakness of Sunak, and the extent, excluding the SNP, of mutual cross-party self-congratulation that permeated Tory and Labour benches.Westminster operates within the framework of a partially written, uncoded, constitution where it is supreme and as the spectacle of the Privileges Committee Report debate was unfolding Humza Yousaf launched the Scottish Government's latest independence paper outlining the path to a written constitution in an independent Scotland. We discuss.We also look at the SNP Special Conference in Dundee this weekend. Is it yet another talking shop where non-allgned Yessers like Lesley are there as "licensed dissenters"? Or will it be an opportunity for SNP members to "take back control"?Sunak wasn't the only missing party leader at Westminster, Sir Keir Starmer was in Edinburgh promoting Labour's Great British Energy Company, to be based in Scotland. Has he outflanked the SNP enough on this to sway Scottish voters?As the video emerged of the "Jingle to Mingle" party at Tory HQ the first phase of the Covid Inquiry saw excoriating condemnation by Professor Sir Michael Marmot not only of the failure to prepare for the pandemic, but the critical damage done by austerity to the NHS and to the health of the population.David Cameron, of course, "didn't accept that description". Osborne, the other architect of the policy, is up next.All this plus fitba, and Twitter bans for Joyce.The next AUOB rally for independence takes place this Saturday June 24th.MARCH FOR INDEPENDENCE- STIRLING SATURDAY 24 JUNE 2023AULD STIRLING BRIG TO BANNOCKBURN FIELDGATHER EARLY, LEAVE 12:30pm SHARPMAKE SURE TO ATTEND THE NATIONAL DEMONSTRATION FOR SELF DETERMINATION #YESMARCH FOR INDEPENDENCE STIRLING - SATURDAY 24 JUNE ★ Support this podcast ★

Soaring food prices mean putting food on the table is a daily struggle. This is the grim reality for millions around the world. But hunger, so long a feature in lower-income countries, is becoming a familiar picture in richer ones too. James Gallagher reports from the UK, one of the wealthiest countries in the world, where food prices are rising at the fastest rate for 45 years and millions are turning to charity to feed themselves and their families. He visits the charities which help people to continue to eat and cook healthy food and hears from Professor Sir Michael Marmot from University College London, who has spent a lifetime researching the consequences of inequality and poverty. Food insecurity, he tells James, damages the health of children and adults.

How do you define and measure health equity and equality? Renowned epidemiologist Sir Michael Marmot, Professor of Epidemiology at University College London, discusses the inequities created by the COVID-19 response in the UK. Professor Sir Michael Marmot CH discusses his recent publication, Build Back Fairer: The COVID-19 Marmot Review, explains the co-benefits of healthcare, and lists ways that we can bring about change to improve health outcomes. Sir Marmot's visit to Australia was hosted by Professor Helen Skouteris, Head of the Health and Social Care Unit, Monash University. Professor Skouteris is also Director of the Centre of Research Excellence in Health in Preconception and Pregnancy  (CRE HiPP), one of the CREs that contributes to the Collaboration for Enhanced Research Impact.

Professor Sir Michael Marmot has been researching health inequalities and their relationship to social injustice for more than 50 years. He has long been a vocal critic of how health inequalities undermine social cohesion and the ability of health systems to respond effectively to pandemics and other health emergencies. Despite being an outspoken critic of austerity and the policies of successive Coalition and Conservative British governments, he was named a Companion of Honour in the 2023 New Year Honour's List. Today Prof Sir Michael Marmot speaks to Mark about Covid-19 and health inequalities as well as his decades-long research into this field.  This interview is featured in our companion episode: ‘All In It Together: Were Unequal Outcomes Inevitable during Covid-19?' Presented by Mark Honigsbaum @honigsbaum With: Professor Sir Michael Marmot Professor of Epidemiology at University College London, Director of the UCL Institute of Health Equity, and Past President of the World Medical Association. https://www.instituteofhealthequity.org/  @MichaelMarmot @marmotihe Series Producer: Melissa FitzGerald @Melissafitzg Co-producer: Kate Jopling  @katejopling Cover art by Patrick Blower. www.blowercartoons.com Follow us on Twitter: @GoingViral_pod     Follow us on Instagram: goingviral_thepodcast  This episode of Going Viral on trust in the pandemic, has been produced in collaboration with the UK Pandemic Ethics Accelerator. A partnership between the Universities of Oxford, Bristol and Edinburgh, University College London, and the Nuffield Council on Bioethics (the Principal Investigator was Professor Ilina Singh, University of Oxford). The Ethics Accelerator was funded by the UKRI Covid-19 research and innovation fund.  https://ukpandemicethics.org/   /  @PandemicEthics_ If you enjoy our podcast - please leave us a rating or review.  Thank you!

When do you think ‘middle age' starts? What about ‘old age'? Unsurprisingly, the answer to these questions will depend on your culture, as well as how old you are when someone asks you. What is perhaps more surprising is that the answer to these questions could have an impact on how quickly your body begins to age.你认为“中年”从什么时候开始？ “晚年”怎么办？不出所料，这些问题的答案将取决于您的文化，以及当有人问您时您的年龄。也许更令人惊讶的是，这些问题的答案可能会影响您的身体开始衰老的速度。In 2003, the researchers Hannah Kuper and Sir Michael Marmot carried out a wide-ranging study in which participants were asked the question: when does old age start? They then followed up with the participants six to nine years later and found that those who had thought old age began earlier were more likely to be in poor physical health.2003 年，研究人员汉娜·库珀 (Hannah Kuper) 和迈克尔·马默爵士 (Sir Michael Marmot) 进行了一项范围广泛的研究，参与者被问到这样一个问题：老年从什么时候开始？然后，他们在六到九年后对参与者进行了跟进，发现那些认为老年开始得早的人更有可能身体健康状况不佳。But how could someone's answer to a question about age possibly have an impact on their health? It might be that the question prompts people to think about their physical health, underlying health issues or poor lifestyle, which might then make them feel that old age is coming sooner. People who say that old age sets in earlier, may also be more fatalistic and less likely to visit a doctor or to adopt healthier routines. It's even possible that the stress of having negative thoughts about ageing, contributes to more health problems.但是，一个人对年龄问题的回答怎么可能对他们的健康产生影响呢？可能是这个问题促使人们思考他们的身体健康、潜在的健康问题或不良的生活方式，这可能会让他们觉得老年会更快到来。说晚年更早的人也可能更加宿命论，不太可能去看医生或采取更健康的日常生活。对衰老产生负面想法的压力甚至有可能导致更多的健康问题。So, this is what happens when we think negatively about ageing, but what happens when we think positively? People who think old age starts later, may be more conscious about their health and fitness and therefore take steps to stay in better shape. They may see their twilight years as an opportunity to learn new things and make new plans. If they believe they are younger, they therefore behave in younger ways, creating a virtuous circle. Whatever the reason, according to data from the Ohio Longitudinal Study of Ageing and Retirement, people who think positively about ageing live longer on average.那么，当我们对衰老持消极看法时会发生这种情况，但当我们积极思考时又会发生什么呢？认为晚年开始的人可能更关注自己的健康和健身，因此会采取措施保持更好的体型。他们可能会将晚年视为学习新事物和制定新计划的机会。如果他们认为自己更年轻，那么他们就会以更年轻的方式行事，从而形成良性循环。不管是什么原因，根据俄亥俄州老龄化和退休纵向研究的数据，对老龄化持积极态度的人平均寿命更长。Of course, none of this research means that a positive attitude can magically stop the ageing process – our bodies get older with each passing year, after all. But it seems that if we try to be healthier and if we believe that there are still things we can do in old age, we might live longer and enjoy ourselves more too.当然，这些研究并不意味着积极的态度可以神奇地阻止衰老过程——毕竟我们的身体一年比一年老。但似乎如果我们努力变得更健康，如果我们相信我们在老年时仍然可以做一些事情，我们可能会活得更久，也会更享受自己。词汇表middle age 中年unsurprisingly 不出所料地have an impact on 对…产生影响age (v) 衰老，变老carry out 进行…，完成wide-ranging 范围广的participant 参与者follow up 跟进，跟踪调查poor physical health 糟糕的身体状况，身体状况不佳how could (something or someone) possibly （某事或某人）怎么可能…prompt (v) 促使underlying 潜在的poor lifestyle 不良的生活方式set in （不好的事情）到来，开始fatalistic 相信宿命的adopt 养成…习惯contribute to 导致conscious 有意识的，在意的take steps to 采取措施stay in shape 保持健康twilight years 暮年，晚年virtuous circle 良性循环ageing process 衰老过程

This episode continues the conversation between Professor Sir Michael Marmot and Dr Jasmine Lee as they discuss the challenges faced now following over a decade of growing health inequity and the current cost of living crisis. Professor Sir Michael Marmot is a Professor of Epidemiology at University College London, the Director of the UCL Institute of Health Equity and the author of The Health Gap: the challenge of an unequal world (Bloomsbury: 2015). He has over four decades of experience leading research teams on health inequities and chaired commissions. Dr Jasmine Lee is a palliative medicine specialist registrar and trainee, RCP clinical education fellow and Association of Palliative Medicine trainees committee co-chair based in London. This episode was recorded in August 2022 before the results of the Conservative party leadership election for the UK Prime minister on 7th September 2022.

Listen to Professor Sir Michael Marmot and Dr Jasmine Lee discuss the impact of social determinants of health inequity looking at research and policies over the years, the important relationship they have to the health of our population and the impact of the Coronavirus-19 pandemic. Professor Sir Michael Marmot is a Professor of Epidemiology at University College London, the Director of the UCL Institute of Health Equity and the author of The Health Gap: the challenge of an unequal world (Bloomsbury: 2015). He has over four decades of experience leading research teams on health inequities and chaired commissions. Dr Jasmine Lee is a palliative medicine specialist registrar and trainee, RCP clinical education fellow and Association of Palliative Medicine trainees committee co-chair based in London. This episode was recorded in August 2022 before the results of the Conservative party leadership election for the UK Prime minister on 7th September 2022.

Just before the Covid-19 pandemic hit, 10 years on from a landmark review by University College London's Sir Michael Marmot's into health inequalities in England, the Institute of Health Equity published a follow-up report exploring just how closely health and life expectancy are tied to socioeconomic position and the conditions in which people live and work. Some of the findings were bleak, underlining that health inequalities had worsened over the preceding decade. In this panel discussion from EG's recent ESG Breakfast Briefing, our guests explored the role real estate and the built environment have in addressing these worsening inequalities. Joining deputy editor Tim Burke are: Rob Charlton, chief executive, Space Group Pete Gladwell, group social impact and investment director, L&G Group Divya Hariramani Herrero, sustainable design and wellbeing service line lead, Longevity Cara Imbrailo, partner, Charles Russell Speechlys Federico Montella, head of ESG and sustainability, Lambert Smith Hampton Jane Mudd, leader, Newport City Council

We are back! And this is an extra special episode to kick us off, with none other than Professor Sir Michael Marmot, the guru of health inequalities. Sir Michael Marmot's work has changed how physicians, public health experts and governments think about health inequity. His work has been cited more than 250,000 times, and his influential Review has spread from the Eastern Mediterranean in 2019 to Manchester in 2021. You might have seen Sir Michael's reports, read his books including The Health Gap, or perhaps you've heard him speak. But for this conversation, we wanted to get to know the man behind the title...*Highlights:Key messages of his work (3.5 mins)Growing up (8 mins)His first interest in health inequalities (13 mins)Changing track (17.5 mins)Politics (29 mins)Persuading people (38 mins)Ten years on (46 mins)Hope (51 mins) *ResourcesRCGP modules on health inequalitiesHis book The Health GapOur other episodes realted to health inequalites- with Bola Owolabi and Laura Neilson *Social media:@MichaelMarmot@NextGGP/ @nishmanek *Subscribe to the Next Gen GP monthly bulletin to keep in the loop:bit.ly/NGGPbulletinhttps://nextgenerationgp.co.uk/ Hosted on Acast. See acast.com/privacy for more information.

In his lecture to the RSA, Professor Sir Michael Marmot will explain that in developing strategies for tackling health inequalities we need to confront the social gradient in health, not just the difference between the worst off and everybody else. There is clear evidence when we look across countries that national policies make a difference and that much can be done in cities, towns and local areas. But policies and interventions must not be confined to the health care system; they need to address the conditions in which people are born, grow, live, work and age. The evidence shows that economic circumstances are important but are not the only drivers of health inequalities. Tackling the health gap will take action, based on sound evidence, across the whole of society.#RSAhealthBecome an RSA Events sponsor: https://utm.guru/ueembDonate to The RSA: https://utm.guru/udNNBFollow RSA Events on Instagram: https://instagram.com/rsa_events/Follow the RSA on Twitter: https://twitter.com/RSAEventsLike RSA Events on Facebook: https://www.facebook.com/rsaeventsoff...

In the latest episode, we hear a stark warning that escalating energy prices will lead to a ‘humanitarian crisis' in the UK. A new report by two leading experts suggests that thousands of lives will be lost and the development of millions of children blighted as a result of fuel poverty, triggered by rising energy prices.The grim prediction comes from Professor Sir Michael Marmot from UCL in London with Professor Ian Sinha, a consultant at Alder Hey Children's Hospital, Liverpool.Sir Michael shares the key findings with Adrian Goldberg. Produced in Birmingham by Adrian Goldberg.Funded by subscriptions to the Byline Times. Our GDPR privacy policy was updated on August 8, 2022. Visit acast.com/privacy for more information.

In the latest episode, we hear a stark warning that escalating energy prices will lead to a ‘humanitarian crisis' in the UK.   A new report by two leading experts suggests that thousands of lives will be lost and the development of millions of children blighted as a result of fuel poverty, triggered by rising energy prices. The grim prediction comes from Professor Sir Michael Marmot from UCL in London with Professor Ian Sinha, a consultant at Alder Hey Children's Hospital, Liverpool. Sir Michael shares the key findings with Adrian Goldberg. Produced in Birmingham by Adrian Goldberg. Funded by subscriptions to the Byline Times.  

Bolsover GP Dr Selina Flinders joins Tara this week to talk about Sir Michael Marmot's brilliant The Health Gap. We talk about health inequalities, the effect of the pandemic and how much more relevant this book sadly is in our post-Covid world. We go on to talk about poverty, intergenerational medicine, the role of the GP as a listener and how the Beveridge report remains just as relevant 80 years later.This is such an important book, it's also readable, accessible and thought provoking without being hard work or boring.  It's relevant to anyone working in healthcare and to be honest we think it's relevant to anyone who is interested in anything.We also talked about Julian Tudor-Hart's Inverse Care Law If you want a reminder: https://www.youtube.com/watch?v=R5zvzKcFHj8Selina also recommended Kristin Hannah's novel The Four Winds  and how the themes in that fit with everything Marmot has to say. We also mentioned Cecil Helman's classic book The Suburban Shaman

Hello! This week we're talking about health inequalities. The evidence has long been clear that your life circumstances determine how long and how healthy your life will be. Over the last decade, life expectancy has stalled and the pandemic has amplified existing inequalities. In the face of this bleak prognosis, we look for optimism with the leading academic on the topic Professor. Sir Michael Marmot, who tells us about the social factors that determine health; Christina Gray, Director for Communities and Public Health for Bristol on the importance of community cohesion; and Chris Gray, Principal Research Fellow at IPPR about the links between health and economic prosperity.Plus: Geoff talks Star Wars and Ed tells us about his run-in with the Chancellor.Show notes:Ed's speech in the Commons: https://www.youtube.com/watch?v=PjtXbwi-2QgFair Society, Healthy Lives (The Marmot Review, 2010): https://www.instituteofhealthequity.org/resources-reports/fair-society-healthy-lives-the-marmot-review Marmot Review 10 Years On (2020): https://www.instituteofhealthequity.org/resources-reports/marmot-review-10-years-on Build Back Fairer: The COVID-19 Marmot Review (2021): https://www.instituteofhealthequity.org/resources-reports/build-back-fairer-the-covid-19-marmot-review Ambition Lawrence Weston: https://www.ambitionlw.org/ IPPR: Introducing the Commission on Health and Prosperity (2022): https://www.ippr.org/research/publications/health-and-prosperity See acast.com/privacy for privacy and opt-out information.

We're collectively gritting our teeth with April approaching, preparing for energy bills soaring in a crisis fuelled by surging demand in Asia, Russia-Ukraine tensions and a spike in natural gas prices.But after years of Conservative austerity policies and a drop in life expectancy caused by Covid, the UK's top health inequalities expert is warning London's poorest families are going to be hit hardest by the energy crisis.Professor Sir Michael Marmot, a highly-awarded epidemiologist and director of UCL's Institute of Health Equity has been researching for decades how social factors influence health, particularly the body's cardiovascular system. See acast.com/privacy for privacy and opt-out information.

Professor Sir Michael Marmot is Professor of Epidemiology At University College London, Director of the UCL Institute of Health Equity and Past President of the World Medical Association. He is author of the hugely popular "The Health Gap". In 2021 Professor Marmot received BMJ's Outstanding Contribution to Health award. In this episode we discuss: The social determinants of health The Marmot Review Build Back Fairer: the COVID 19 Marmot Review How individual clinicians can combat health inequalities Marmot Review 10 Years On: https://www.instituteofhealthequity.org/resources-reports/marmot-review-10-years-on Build Back Fairer: The COVID-19 Marmot Review: https://www.instituteofhealthequity.org/resources-reports/build-back-fairer-the-covid-19-marmot-review Doctors for Health Equity - World Medical Association Report: https://www.instituteofhealthequity.org/resources-reports/doctors-for-health-equity-world-medical-association-report For comments, collaboration or feedback, contact us via email or Twitter. Email: medspirepodcast@gmail.com Twitter: @medspirepodcast

Adrian Goldberg investigates one of the great scandals of our time – the health inequalities that mean a man living in central Blackpool can expect to die 27 years earlier than his counterpart in an affluent district of London... That stark figure – from research by Imperial College in London – showed that, life expectancy for women fell in almost one in five communities in England in the decade before the pandemic…whilst researchers at York University's Centre For Health Economics found that cuts led to 57,000 deaths more than would otherwise have been expected in the four years after Austerity was implemented in 2010 by the coalition government. Adrian is joined by Professor Sir Michael Marmot, Director of the Institute of Health Equity at University College London and Byline Times writer Sam Bright whose book Fortress London, Why We Need To save The Country From Its Capital is available now on pre order.Produced by in Birmingham UK by Adrian Goldberg and Harvey White.Funded by subscriptions to the Byline Times newspaper See acast.com/privacy for privacy and opt-out information.

Adrian Goldberg investigates one of the great scandals of our time – the health inequalities that mean a man living in central Blackpool can expect to die 27 years earlier than his counterpart in an affluent district of London...   That stark figure – from research by Imperial College in London – showed that, life expectancy for women fell in almost one in five communities in England in the decade before the pandemic…whilst researchers at York University's Centre For Health Economics found that cuts led to 57,000 deaths more than would otherwise have been expected in the four years after Austerity was implemented in 2010 by the coalition government.   Adrian is joined by Professor Sir Michael Marmot, Director of the Institute of Health Equity at University College London and Byline Times writer Sam Bright whose book Fortress London, Why We Need To save The Country From Its Capital is available now on pre order. Produced by in Birmingham UK by Adrian Goldberg and Harvey White. Funded by subscriptions to the Byline Times newspaper

Part 2 - Uncaring: How the Culture of Medicine Kills Doctors & Patients w/ Robert Pearl, MD. Tune into Swift Healthcare Podcast to hear Robert Pearl, MD discuss his new book which has already become a #1 New Release in multiple Amazon categories and is soon to be a NY Times Bestseller! Ranked a Top 60 Healthcare Leadership podcast by Feedspot. In his new book, Dr. Pearl shines a light on the unseen and often toxic culture of medicine. Today's physicians have a surprising disdain for technology, an unhealthy obsession with status, and an increasingly complicated relationship with their patients. All of this can be traced back to their earliest experiences in medical school, where doctors inherit a set of norms, beliefs, and expectations that shape almost every decision they make, with profound consequences for the rest of us. Robert Pearl, MD Links: https://robertpearlmd.com https://robertpearlmd.com/books/ https://www.linkedin.com/in/robert-pearl-m-d-32427b98/ Music Credit: Jason Shaw from www.Audionautix.com THE IMPERFECT SHOW NOTES To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we'd love to offer polished show notes. However, Swift Healthcare is in its first year.  What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it's close enough - even with the errors - to give those who aren't able or inclined to audio interviews a way to participate.  Please enjoy! Transcript Patrick Swift, PhD, MBA, FACHE: [00:00:00] [00:00:00] Welcome folks to another episode of the Swift healthcare video podcast. I'm delighted that you're here and I have an amazing guest for our episode to Dr. Robert Pearl. Welcome back to the Swift healthcare video podcast, Dr. Pearl. [00:00:13] Robert Pearl, MD: [00:00:13] It is a privilege to be back, Patrick , looking forward to it all week long. [00:00:17] Patrick Swift, PhD, MBA, FACHE: [00:00:17] I'm glad, I'm glad. I'm glad. And we are talking about your book that is coming out Uncaring: How the culture of medicine is killing doctors and patients. I'm going to say that title again. It is packed Uncaring: How  the culture of medicine is killing doctors and patients. And in this episode, last episode, hopefully you've dialed in and heard that one. [00:00:40] This episode, we're going to be talking about doctors. We're going to be talking about providers and it wouldn't do justice without giving  a little intro for Dr. Pearl here. So Dr. Pearl bear with me and for listeners, please take this in who you're listening to. This is Dr. Robert Pearl. He's the former CEO of the Permanente medical group, [00:01:00] the nation's largest medical group. [00:01:01] At the time he was there in 99 to 2017, former president of the Mid-Atlantic Permanente medical group, 2009 to 17. He's led 10,000 physicians, 38,000 staff. These are people that get up in the morning and report to work. We're looking at 50,000 plus that he supported, uh, 5 million Kaiser Permanente members. [00:01:20] He's been listen to this named one of modern healthcare's 50 most , influential physician leaders. And you're listening to him right now. He has a. Authored several books I'm gonna  touch on that, but he's also hosting podcasts, fixing healthcare, another one, Coronavirus, the truth. And then he has a newsletter Monthly Musings on American healthcare. [00:01:42] He's a regular contributor to Forbes. And the first book I'm sure we'll touch on one was Mistreated: why we think we're getting good healthcare and why we're usually wrong. Holy crap. That is just a great title. Uh, and then this new book coming out, uncaring, how the culture of medicine kills doctors and patients.  With that [00:02:00] said the intro, Dr. Pearl, let's just jump right into it. And, , you have done some amazing things. I want to ask you number one, thanks for being on the show [00:02:10]Robert Pearl, MD: [00:02:10] Thank you. [00:02:11] Patrick Swift, PhD, MBA, FACHE: [00:02:11] Two , uh, we're talking about providers, folks, This book that's coming out is supporting doctors without borders, all the , all the proceeds of the goes to the doctors, to the borders. He's done some really cool stuff involving Ebola response to tsunamis, and I've got to pick his brain, uh, just because, um, share some insight being there. We're talking about providers, we're talking about professionals, we're talking about physicians. Um, what was your experience supporting providers, physicians, um, particularly, um, but supporting providers in response to Ebola and, uh, the tsunami [00:02:45] The tsunami was fascinating because it was a lot more than just physicians. A lot of psychologists actually participated because the mental health issues of the people in Sri Lanka, which is where we went along with doctors without borders, [00:03:00] uh, was tremendous. So this happened, people may remember a little over a decade ago, a tsunami hit the area. Uh, it was the day after Christmas, but we knew that there were a lot of people who were killed, harmed and about to be harmed because the upcoming diseases with the communicable diseases and the contaminated water or the malaria then invariably would come. And so we worked with doctors without borders, uh, to figure out how we could send teams of volunteers there. I sent a secure email out to my physicians. Uh, they 10,000 of them. And I said, how many of [00:03:47] day after Christmas. [00:03:49] Robert Pearl, MD: [00:03:49] The day after  Christmas? So half of them were on vacation with their family. And I said, how many of you would be willing to volunteer? And they're not going to get paid. We'll provide the [00:04:00] supplies. We'll provide the transportation, but they're, they're on vacation. [00:04:03] This is their vacation to go to Sri Lanka. And then of course I'm a physician. So I have to provide informed consent. Number one, there may not be any food. Number two, the water could easily be contaminated. And number three there's been a civil war for 20 years. I figured maybe I get five or six over 200 people volunteered that week. [00:04:26] Or we ended up sending 10 trips, saving tens of thousands of lives, providing the psychological support to them, avoiding malnutrition, avoiding death from diarrhea, avoiding malaria, all the different pieces, depending upon how the epidemic happened. And then we said teams to Guatemala. After the earthquake struck there, we sent teams to the South. [00:04:55] After hurricane Katrina to Louisiana, we sent them [00:05:00] a great story. They arrived there and the police have a barricade up. So no one can come into the area where Katrina has been. So what do they do? They rent a car at night and they go around the police barricade so they can get in there and provide care to these people who were in tremendous need. [00:05:17] And then the Ebola comes, uh, Liberia and the physicians there. And they're all physicians in this case because you need infectious disease, expertise and emergency expertise. They actually have to have IVs going into their arms while they're providing care, because they're wearing the protective suits that are so hot. [00:05:36] It's 120 degrees inside the suit. [00:05:39] Patrick Swift, PhD, MBA, FACHE: [00:05:39] Oh my God. [00:05:39] Robert Pearl, MD: [00:05:39] are alive unless they're receiving IVs. [00:05:43] Patrick Swift, PhD, MBA, FACHE: [00:05:43] Oh my God. [00:05:44] Robert Pearl, MD: [00:05:44] And this to me is the amazing piece. Patrick, I talked to  everyone who came back. Now just try to think about what it's like to be, be there. That 120 degree suit we're sitting there in the midst of a tsunami with knowing that there's civil war around you or the [00:06:00] hurricane debris of, uh, of central America. I have never seen happier physicians. The ones who went there made me think about all the trips that I've done. I fixed kids with cleft lip and cleft pallet. I've probably done a dozen trips to central South America, to some other countries as well. You know, you go there, you work 12 hour days, the ORs are not air conditioned. [00:06:23] Food is rice and beans and everyone comes back fulfilled. Now think about in the context of burnout, what is missing? It's not the comfort, it's not the money. It's the mission and purpose. I think that we have lost that. And that's part of why I wrote on caring, how the culture of medicine kills doctors and patients, because I think some of it, much of it has been done to us, but much of it we've done to ourselves. [00:06:53] And hopefully we'll get into that in greater detail. So people can start working on ways to [00:07:00] minimize the harm that they're experiencing. [00:07:02] Patrick Swift, PhD, MBA, FACHE: [00:07:02] Yeah, your a story. It brings tears to my eyes. You're just talking about these people who are, um, volunteering. I mean, it's hope you speak about hope, Dr. Pearl. There's so much pessimism and confusion and misinformation and, and sarcasm and negativity and your story of expecting five and you get 200, um, people putting them their, their lives at risk, um, uh, giving up not only just vacation, but risking their lives, um, in Liberia and, and, and Sri Lanka. And, and these are stories of, of the reason why we go into healthcare. We all want to make that difference. Healthcare people are mission-driven people. And what you're talking about is, uh, facilitating folks, being able to follow their Dharma, follow their calling. And I know in the previous episode, we talked about you following your Dharma and your calling, and, um, it's so beautiful. [00:07:57] That's why we go into healthcare we're mission [00:08:00] driven people, and you touch on being done to us as providers and doing it to ourselves, and that leads to a conversation about culture. Um, and, um, uh, I'm curious about your thoughts in this, in light of the amazing book that you have coming out, um, your thoughts about culture and how we're doing this to ourselves. [00:08:20], in light of, , this episode, focusing on providers and physicians. [00:08:24] Robert Pearl, MD: [00:08:24] If you ask physicians, why are 44% of physicians burned out? And why do they talk about moral injury? They'll tell you it's three things. At least the three most common we don't get paid enough. We have to do so many bureaucratic tasks and the computers in the exam rooms and the offices are so slow and clunky. [00:08:52] They make a spend a huge amount of time documenting rather than providing the care. [00:08:59] Patrick Swift, PhD, MBA, FACHE: [00:08:59] that is [00:09:00] maddening. I got to tell you. [00:09:01] Robert Pearl, MD: [00:09:01] And they're all right, all those three things are there. But I wrote the book because my first book mistreated was about the systemic issues. And as I went around talking to people and I researched areas like burnout, there was still a piece missing. [00:09:21] So let me give you a couple of examples. The people who were paid the least are pediatricians, but their rate of burnout is not that high, primary care is a much higher rate of burnout than pediatrics, even though the salaries are higher. What was even more amazing to me was the specialty that had the highest rate of burnout over 50% is urology. [00:09:48] Now think about it. Urologists make almost a half million dollars a year. It's not the salary. They're making as much money now as they did in the past, when they [00:10:00] had low rates of burnout and compared to orthopedics or ophthalmology, they make just as much money, but they have 20% higher burnout rates. [00:10:12] How do you explain this? It's not a lack of salary, because they're making a lot more than primary care and just as much, and even more than the other specialties, it can't be the bureaucratic tasks that goes into the same authorization processes. They have the same restrictions, the same regulations, and they're using exactly the same computers. [00:10:31] So there's nothing different that explains it. If you look at the data over time, you start to see an interesting phenomenon, which is that urology used to have a low burnout rate, similar to some of the other surgical specialists specialties. And then what happened almost a decade ago is that the national preventive care oversight groups. [00:10:50] Decided that the PSA, the prostate specific antigen that's used to find prostate cancer was causing as much harm, as good as [00:11:00] people underwent a huge number of biopsies and other tests. And people were also discovering that lo and behold, not intervening had as good a long-term expectancy in a lot of cases without the risk of impotence and urinary incontinence. [00:11:18] And so the number of cases they did start going down a why is that important? Because in the hierarchy of medicine, it's not rational in the hierarchy of medicine, the cooler, the procedure, and this robotic prostatectomy, it's like a star Wars of surgery gave urologists this high status. And now as fewer and fewer urologists can do the procedure or have the opportunity to do the procedure. [00:11:51] All of a sudden this level of satisfaction. One that's not created from the outside, because remember I said, urologist's are  making just as much [00:12:00] money, but simply from this hierarchy of medicine, I'm sure you're familiar with the work of Sir  Michael Marmot who looked at the relative hierarchies in British society amongst workers. And he could show a clear correlation. The lower down you were, the more dissatisfied, unfulfilled, fatigued. You were the exact same symptoms as burnout. [00:12:26] Patrick Swift, PhD, MBA, FACHE: [00:12:26] beautiful point and you're not picking on urologist, obviously you're not, but I think it's worth pointing out. You're not picking on urologists. You're you're pointing out. You're shining a light on culture. And how we, we, like you said, we do to ourselves, we get caught up in this hierarchy and socially our families and culture and environment looks at us in pressure. [00:12:48] There's this whole environment. you get to the, you get to 40 and don't give a shit what people think you get to 50. You don't give a fuck what people think I'll , bleep that out. But, but the notion that as you get older, you have to recognize praise and blame weigh the [00:13:00] same. [00:13:00] All these, all this external, um, is,  Maya, this illusion , this, this farce. And so you're speaking to one is the  Occams' razor of cutting right through it. And that even saying that you breathe a little clearer of, of recognizing your own value. And that's the coaching I do as a psychologist and as an executive coach, it's about cutting through. [00:13:23] So personally, there's that decision you touch on the other is now the culture, external culture. What can we do to move that culture, Dr. Pearl? Because your voice is so powerful that it speaks to putting a light on this, but there's also organizational institutional cultural things that, that, that needs to happen in order for this to shift in medicine. [00:13:44] Right? The incentive. [00:13:46] Robert Pearl, MD: [00:13:46] So, this is the piece of the book that I think is the most important, which is the way that culture and system move together. [00:14:00] So if you're going to try to create, you're going to try to create a, a logical way to say which specialties should be near the top of the hierarchy. And I told you that adding 10 community increases longevity two and a half times more than adding 10 specialists, you would say primary care should be at the top of the hierarchy. And yet they are not now in the minds of a lot of physicians, the order is we're not paid a lot, so we're not at the top of the hierarchy. And I'm making the point in this book that some of the reason why primary care is not paid as much is because the physician hierarchy does not put them higher enough. [00:14:43] Because when you look at groups, the Mayo clinic or Kaiser Permanente, what you see as their primary care physicians are paid a lot more than in the community, because their value is seen more clearly. [00:14:56] Patrick Swift, PhD, MBA, FACHE: [00:14:56] say that again. Please say that again.  [00:15:00] did you just say, I think I heard you say this, but I want our listeners to hear this. You just said in the Kaiser Permanente group, the primary care are compensated more because they're valued for the life-saving essentially, now  I'm putting words in your mouth, but it's also impacting preventing it saving lives. [00:15:19] Is that what you said? That there's more compensation? [00:15:22] Robert Pearl, MD: [00:15:22] If you look around the United States, I was also the chairman of the accountable care organization. And we had 24 groups, including the Mayo clinic and the Kaisers and the Geisinger's ad. And every group primary care is paid more in a group practice than it is an individual. But what, so what can be done? [00:15:41] I think that physicians, [00:15:43] Patrick Swift, PhD, MBA, FACHE: [00:15:43] one is they move their right to be part of that culture. [00:15:49] Robert Pearl, MD: [00:15:49] the good part is they wouldn't have to move there [00:15:51] Patrick Swift, PhD, MBA, FACHE: [00:15:51] Okay. How [00:15:53] Robert Pearl, MD: [00:15:53] I think in the post, I think in the postcard, a virus era, there will [00:16:00] be everywhere. And what I mean by that is the following. You know, the United States will have borrowed $8 trillion that we'd have to pay back or we'll have to pay interest on by law every state in the United States has to have a balanced budget. They're going to have more unemployment claims, more Medicaid and less revenue. And small businesses that are the engine that drives employment. The people that drive the stock market are Amazon, Netflix, Apple, but the people who drive employment are this small businesses and they've been hammered a third of them saying they can't actually get through this year. [00:16:39] without  continued government support. You know, we've talked about the need to lower the cost of healthcare for decades instead of we should. We must. I'm saying now that we will, because people won't be able to afford to pay the projected five to 6% costs [00:17:00] increased year over year. And when you can't afford something, you don't do it even if you want to do it. [00:17:07] And I think that that's where our nation is going to be, and we're going to face. [00:17:11] Patrick Swift, PhD, MBA, FACHE: [00:17:11] So hang on. Are you saying then that I agree with you that people are less likely to go to the, basically they're less likely to go to doctors. Ones are likely less likely to have procedures done those less likely to get care. They're less likely to get screening. So then mortality increases and then there's death. [00:17:31] We're talking, we're talking over more mortality. So where, where is the, where's the solution here? How do we, how do we get, how do we address this before the tsunami, um, of poor care? Comes because of lack of access because of lack of resources to be able to pay for it. [00:17:51] Robert Pearl, MD: [00:17:51] Look at the options you have, where you have a budget that cannot be exceeded a fee for [00:18:00] service system, which providers can just do more and more can't work. So you're left with two options. We'll either ration care or we'll transform care. Under a single payment, the technical word is capitation. And here's where the interesting part starts, which is that the physician culture that for decades has avoided progress because it's been the interest of physicians and hospitals and others to be paid in a fee for service type way when that's no longer possible. [00:18:34] And the choice shifts into one of rationing versus capitation. I think we're going to see people start to move forward. Not everyone at once, but some people will move forward. I'm hopeful. It's going to be similar to when Roger Bannister broke the four minute mile. Once some people are doing it, as you know, with it, it was thought to be [00:19:00] impossible. [00:19:00] And there were three years, there were 10 people who had done it because now once you're in a capitated system, you see the culture start to change. And what do I mean by [00:19:09] Patrick Swift, PhD, MBA, FACHE: [00:19:09] Your lips to God's ears. [00:19:11] Robert Pearl, MD: [00:19:11] Well, what you see is that in a capitated system, prevention becomes far more important. Primary care becomes far more important. Patient safety avoids a complication for chronic disease. All of these become positive [00:19:29] Patrick Swift, PhD, MBA, FACHE: [00:19:29] and this is a provider, this is a provider of focus. Right? And so satisfaction goes up, [00:19:35] Robert Pearl, MD: [00:19:35] and exactly, [00:19:36] Patrick Swift, PhD, MBA, FACHE: [00:19:36] provider experience goes up the, the quality of life work-life balance. All of the benefits. There is a sea change for us as providers with that kind of model. [00:19:48] Robert Pearl, MD: [00:19:48] where you ha you start to have the control, but you also have the risk. And this is why I think it's the risk aversion of physicians. That's kept them out of the model, but once you have the [00:20:00] risk, you need to find ways to obviate it, which means you've got to form groups. Working together in collaborative and cooperative ways, which I think psychologically is far better than everyone out for themselves. [00:20:16] You have to find technology that's going to work. I mean, look what happened in COVID all of a sudden physicians started doing 60 to 70% telemedicine patients got better care. Everyone's talking about it as it as good. The fact that can address your problem right now, rather than telling you to come back. [00:20:36] I mean, when I was the CEO in Kaiser Permanente, we set up a system whereby if a patient was seeing a primary care physician, this was pre COVID and the physician wanted to send the referral rather than sending a referral. We created a video link with a specialist. Dermatology was a great example of this. [00:20:55] I don't know what it's like in your community. Most places in the United States, this is a six week wait, [00:21:00] the primary care physician, rather than telling the patient call. The dermatologist took a digital picture. Sent it to a dermatologist who was assigned that day to oversee this entire area for, for quite a number of physicians. [00:21:14] and , within six minutes, there was an answer. So care was started that day, not six weeks later. How can you say this inferior care to seeing a doctor in his or her own office six weeks from now that opportunity physicians will figure out and I have tremendous faith that they will do the right things for patients. Once the incentives align and the culture evolves. [00:21:43] Patrick Swift, PhD, MBA, FACHE: [00:21:43] You said something profound to me in another conversation we had in which you said, you tell me the incentives and I will tell you the behaviors. Is that what you said? Am I quoting you correctly? Or the outcomes you tell me the incentives. And you said, you tell me a sentence and I can [00:22:00] tell you what's gonna happen. [00:22:01] Robert Pearl, MD: [00:22:01] I can tell you how people are going to behave. [00:22:02] Patrick Swift, PhD, MBA, FACHE: [00:22:02] Yeah, yeah, yeah. [00:22:04] Robert Pearl, MD: [00:22:04] commonly used business school phrase that somehow it in the culture of medicine, we don't think it's true. We don't think that the 30% of procedures that we do that have been shown to add no value. And I'm talking about by the Mayo clinic and a new England journal of medicine summaries of this that's somehow that's the right thing to do because the culture of medicine tells us somehow that it's okay. [00:22:30] The reality says that is money, we could be better investing whether we want to invest it in prevention, whether we want to invest it in more primary care, whether we want to invest it in better education to make up for what's happened in COVID. Whether you want to invest in development of cities, I can come up with a lot of reasons why it is wasted. [00:22:51] It makes us overlook things like surprise billing. I mean, the fact that we not only give people bills when they come to [00:23:00] get care, because we're battling an insurance company and we put the patient in the middle and then the hospitals that employ us Sue the patient when they can't pay. And we talk about moral injury, talk about inflicting  harm the culture. Doesn't let us see it. You're the psychologist. But to me, it's like a fine grain sieve. It seeps out. And I believe that it erodes the purpose and the mission. And I think that it contributes to the 400 suicides of physicians a year. [00:23:33] Patrick Swift, PhD, MBA, FACHE: [00:23:33] Yeah. Grossly underestimated too. [00:23:35] Robert Pearl, MD: [00:23:35] both doctors and patients. [00:23:37] Patrick Swift, PhD, MBA, FACHE: [00:23:37] Yeah. Yeah. Ah, yeah, incredible. And this episode is your message is one of hope in the face of, you know, full circle in the face of acknowledging, , physician suicide, , the degree of suicide, , in providers and quite frankly, in the country and on a global scale, , providers around the planet right now, moral distress, everything we're going through, , to [00:24:00] the scope of this conversation about the culture of the self-inflicted wound and this wound we're born into, , , in medicine in a previous episode, we taped together, Dr. Pearl, you acknowledged a culture from the 18 hundreds. , and so the environment we're working in and beginning this episode, when you brought tears to my eyes, talking about Liberians, the tsunami, , this is there's such sacrifice on the part of our, our patients. And on the part of our providers, , there is such sacrifice in that his heart, , and what you speak of your message here is one of courage. , the, the courage, , to do something about this and your book is about that. Is it not [00:24:41] Robert Pearl, MD: [00:24:41] Uncaring other culture, medicine kills docs and patients. It is. And I point out in one last thing and again, colleges, so you're more of an expert than I am to this, but the five stages of loss or grief, the Kubler Ross has the fond. And my understanding is they really can't be avoided. [00:25:00] And so the viewers should understand that they may not feel it's going to be necessary. [00:25:06] They're going to deny the change is going to be there. And I hope that they're right, but I don't think they will be for the reasons that we said, and then what's going to happen. They're going to get angry because they feel like something's being done to them. I think some of that's already started [00:25:21] Patrick Swift, PhD, MBA, FACHE: [00:25:21] Oh yeah. [00:25:21] Robert Pearl, MD: [00:25:21] looked at the issue of moral injury as an example of burnout. Then what happens? Third, they start to bargain. Okay, I'll do it Tuesday and Thursday, but not Monday, Wednesday and Friday. I'll do it for some patients and not others. And then they get depressed. And I'm worried about that phase. And I'm hoping that they're going to get through that phase to acceptance, which is not the same thing as saying, it's what I want the saying under the circumstances, it's the best option that's there. [00:25:49] And I'd be a miss to not also mention the article I'll be publishing in Forbes next week, about the impact of COVID-19 [00:26:00] on physicians, particularly in critical care and in infectious disease, the newest Medscape's study has shown that actually urology is now number four with critical care and ID above because of the experience. I think these physicians are having, I talked to one doctor who said he lost four patients in one day. I talked to another one. She was a resident and she said that on day one of the rotation, she inherited six patients. By the end of the month later, they were all dead. I talked to people who are a woman, who's a double boarded physician, probably the grittiest smartest person. I know. And she said she can't go to sleep at night. And she wakes up before sunrise and sweats, sweating in bed. Uh, I think that we have got to understand that PTSD doesn't happen in the midst of the war. It happens afterwards. And I'm hoping [00:27:00] that if listening in are people who run residencies who run hospitals, this is the time to make sure that the psychological resources are there as a conversations can happen. If not, we're going to see as you call it a tsunami of problems with these individuals who have dedicated their life. And risked their life to take care of people infected with this horrible Corona virus pandemic experience. [00:27:30] Patrick Swift, PhD, MBA, FACHE: [00:27:30] Absolutely. And, and I really want to encourage folks to take a look at Dr. Pearl's book, because it is a message of truth, recognizing what is going on here, but it's also a message of hope. There's the question of what can we do? And Dr. Pearl earlier you touched on, um, I, I wanted to bring up, , seeing the stages of grief, , and getting to that acceptance and that not being just, okay, I'm going to just take it, but it's about personal [00:28:00] leadership. [00:28:00] I'd add personal leadership and professional leadership. That's the work I do with, with people is the personal professional leadership is about seeing things as they are not worse than they are. Not better than they are, but seeing things as they are. And then what do we do? And I know they're going to be QANON and wing nuts and people with propagating all kinds of garbage, um, as we have to adjust. [00:28:23], but the vast majority of us are reasonable people, , who bring heart to what we do in caring for our patients and caring for our system. , and, and I couldn't think of a more, , global voice, um, to bring, , courage, compassion, joy, and hope, in the work we do. So it's my prayer that this episode may lift uplift people. And I, and I get to ask you my favorite question at the end of the show here, which is if you had the attention of all the healthcare professionals around the whole planet for a brief moment, what would you tell them? Dr. Pearl. [00:28:55] Robert Pearl, MD: [00:28:55] First thing I would tell them is that the [00:29:00] culture of medicine is getting in the way of fulfilling the reason they chose medicine in the first place that the systematic problems around us they're real. But you know, the people in generations before us. They didn't have effective treatments or they didn't have necessarily the right procedures to perform . There's always difficulties that need to be overcome. And in this particular situation, I think the physician culture and again I  called the physician culture is really a clinician culture. It's just that I'm more knowledgeable. A lot of physicians is getting in the way, you know, the fact that, um, hypertension, the number one cause of strokes and kidney failure is controlled 55 to 60% of the time across , the country. And there are groups, large medical groups that control at 90%. That's not [00:30:00] a criticism. It's just the fact as you point out the question is what are we going to do about it? In the last episode, we talked about racism and the fact that black patients don't receive the same care as white patients, there's systemic issues as well. But the things that we can control. Again, you're the psychologist, but my sense is start with what you can do rather than starting with what you can't do and what you often will find that as you start to do the things that you can to raise quality, to provide care, that's more convenient, that's  more compassionate to be able to make care more affordable, low and behold. [00:30:42] You're going to discover that the happiness and fulfillment that you experience, whether it's a combination of gratitude or there's a combination of being generous is going to come back and have people become more satisfied. I go [00:31:00] back to the tsunami experience, international experience, the happiest people I ever saw were clinicians who went over there and were able to do the right thing. Despite the fact that as you say that you volunteered, despite the risks that were out there, despite the hours, we need to work to change the system, but we also need to work to change the culture. [00:31:25] Patrick Swift, PhD, MBA, FACHE: [00:31:25] incredible, incredible, Dr. Pearl , if folks are interested in following up with you learning more about your podcasts, your newsletters, the book, uh, where can they go? [00:31:34] Robert Pearl, MD: [00:31:34] Best place to go is the website, RobertPearlmd.com. RobertPearlmd.com. They can order the book, pre-order the book. And if they pre-order the book, they'll get the signed book plate to discussion guide. They'll get the bibliography and they'll get the book delivered to their home. On the first day it's available. [00:31:53] Uh, they could also get a lot of other information on the monthly musings on the articles that are being [00:32:00] written, the opportunity to broaden the knowledge and in all of my monthly musings, I always ask for reader feedback. And when it comes to this book, I'm encouraging people. Please read it if you love it, or you hate it. If you agree with it or disagree, let me know. That's how I learned. And I want to learn from all of your viewers and from all of the people who already are following the things that I get a chance to write and say, it's just a privilege to be able to work to transform medicine on behalf of people. And I appreciate all of you viewers who are going to come along on this journey, [00:32:35] Patrick Swift, PhD, MBA, FACHE: [00:32:35] I pray they do. And he does read his email folks and, and the proceeds of the book goes to [00:32:41] Robert Pearl, MD: [00:32:41] Doctors without borders, a tremendous organization that is running healthcare for those who can't contain it around the globe. [00:32:51] Patrick Swift, PhD, MBA, FACHE: [00:32:51] Love them, love them. Outstanding, Dr. Pearl. It is a pleasure and an honor. Thank you so much for being on the Swift  healthcare podcast. Thank you so much for the heart and courage and [00:33:00] joy  and compassion that you bring to the show. [00:33:02] Robert Pearl, MD: [00:33:02] Thank you, Patrick. I've had a lot of fun and I really appreciate you taking the time and educating your viewers. I can't wait to hear their feedback. Thanks so much.

Professor Sir Michael Marmot is Professor of Epidemiology at University College London, Director of the UCL Institute of Health Equity, and Past President of the World Medical Association. 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).  Professor Marmot holds the Harvard Lown Professorship for 2014-2017 and is the recipient of the Prince Mahidol Award for Public Health 2015. He has been awarded honorary doctorates from 18 universities. Professor Marmot has led research groups on health inequalities for over 40 years. He chairs the Commission on Equity and Health Inequalities in the Americas, set up in 2015 by the World Health Organizations' Pan-American Health Organization (PAHO/ WHO).  He was Chair of the Commission on Social Determinants of Health (CSDH), which was set up by the World Health Organization in 2005, and produced the report entitled: ‘Closing the Gap in a Generation' in August 2008. Professor Marmot served as President of the British Medical Association (BMA) in 2010-2011, and is President of the British Lung Foundation.  In 2000 he was knighted by Her Majesty The Queen, for services to epidemiology and the understanding of health inequalities. Today we discuss his 2015 book The Health Gap: the challenge of an unequal world, available at Bloomsbury - https://www.bloomsbury.com/uk/the-health-gap-9781408857991/ If you find this podcast valuable, rating it 5 starts and leaving a review on iTunes, Spotify or Facebook is a huge help. You can find more podcasts, information and social media at www.thegpshow.com  If you would like to provide feedback or request a topic, please Contact Us. Thank you for listening and supporting.

In this episode we have a full version of the conversation we had with Professor Sir Michael Marmot. He scarcely needs introduction for his pioneering work on the social determinants of health. As many of you will know we have just passed the 50th anniversary of the publication of the article in which Julian Tudor Hart wrote about the inverse care law. Sir Michael recorded this interview and we used a slightly shorter video version for the opening of our recent BJGP Webinar on health inequalities. If you want to watch the webinar then visit https://www.bjgplife.com/webinar (www.bjgplife.com/webinar). The video version is, of course, included with that as well as all the other excellent speakers and panel discussion.

Professor Sir Michael Marmot joins Jessamy and Gavin to discuss how inequality and injustice have directly contributed to poorer COVID-19 outcomes, and what has to change in society post-pandemic.

COVID-19 has exposed and amplified the shocking pre-existing health inequalities in the UK. In this week's episode, we're embodying the January spirit of new year's resolutions and looking to the future to see what needs to happen to make our communities safer and fairer.At the end of last year, the Institute of Health Equity released their report Build Back Fairer: The COVID-19 Marmot Review. Inspired by the mantra “Build Back Better” the report, written by Michael Marmot, Jessica Allen, Peter Goldblatt, Eleanor Herd and Joana Morrison, aims to summarise the inequalities, both in terms of those created by the pandemic and the ways it has impacted society, and make recommendations for the future. In today's episode, we speak to Professor Sir Michael Marmot to find out more.More info: www.ucl.ac.uk/ucl-minds/coronavirusTranscript: www.ucl.ac.uk/ucl-minds/podcasts/coronavirus/transcript-episode-34If you've got a question about the pandemic you'd like UCL researchers to answer, please get in touch by emailing UCL's Communications and Marketing team on minds@ucl.ac.uk – we'd love to hear from you. See acast.com/privacy for privacy and opt-out information.

COVID-19 has exposed and amplified the shocking pre-existing health inequalities in the UK. In this week’s episode, we’re embodying the January spirit of new year’s resolutions and looking to the future to see what needs to happen to make our communities safer and fairer. At the end of last year, the Institute of Health Equity released their report Build Back Fairer: The COVID-19 Marmot Review. Inspired by the mantra “Build Back Better” the report, written by Michael Marmot, Jessica Allen, Peter Goldblatt, Eleanor Herd and Joana Morrison, aims to summarise the inequalities, both in terms of those created by the pandemic and the ways it has impacted society, and make recommendations for the future. In today’s episode, we speak to Professor Sir Michael Marmot to find out more. BBuild Back Fairer: The COVID-19 Marmot Review: http://www.instituteofhealthequity.org/resources-reports/build-back-fairer-the-covid-19-marmot-review More info: www.ucl.ac.uk/ucl-minds/coronavirus Transcript: www.ucl.ac.uk/ucl-minds/podcasts/coronavirus/transcript-episode-34 If you’ve got a question about the pandemic you’d like UCL researchers to answer, please get in touch by emailing UCL’s Communications and Marketing team on minds@ucl.ac.uk – we’d love to hear from you.

Sir Michael Marmot is the world expert on health inequality and an advisor to the World Health Organisation. He spoke to us about the potential health costs of an economic recession, and how they might be avoided.

This week HSJ Health Check examines the latest developments on the government’s “40 new hospitals” election promise, particularly the brand new £20bn construction framework through which this ambitious target would be taken forward. We also turn our attention to another of this government’s declared health priorities – prevention – including Sir Michael Marmot’s latest findings; and deputy editor Dave West’s dossier on how evidence that life expectancy and mortality rates are faltering go back eight years. Also featuring Annabelle Collins, Nick Carding and Jack Serle.

An interview with Sir Michael MarmotShow Notes I was honoured to have a conversation with Sir Michael Marmot just a few weeks before The Marmot Review 10 Years On is due to be released. He told me the report has been performed in ‘the spirit of self examination' to see if there has been any impact or if any good has come from the original report (2mins). He mentions the importance of the report amid the current context of worrying life expectancy figures (2m45s) and sheds some light on the reasons behind these worrying trends (4m40s).Sir Michael Marmot is world renowned as a specialist in the impact of inequalities on health with internationally acclaimed research, writing and public speaking on the topic. The professor talks to us about how he perceived his role in all of this (8mins) as someone who synthesises evidence and chains of reasoning (10m40s) to formulate recommendations. Despite being an international spokesperson for such an important issue, Michael tells me that he doesn't see himself as particularly political (12m50s) but does feel able to present information ‘in the spirit of social justice.' We discuss if the moral case is enough to inspire or create political change (13m30s) and how to create action around health inequalities. With years of experience of sounding the claxon for this important issue, he gives his views on how we unite people around this goal and how to deal with actors in the system that might not prioritise equity (15m 30s). With government promising more spending we talk about current opportunities for spending in areas that are most in need (17.30) and gives hope that there will be clear recommendations coming out of the report for where government should direct their resources. We talk about practical action for health professionals too with six recommendation of how we as health professionals can take steps try to tackle health inequalities (19mins).With climate change likely having the biggest impact first to those most disadvantaged and in need, Michael is aware of the current importance of climate change and environment. He shares with us how he is involved in trying to bring the environmental and social determinants of health agendas together and how actions to improve health can contribute to meet carbon neutrality (23mins).To finish we ask for Michael's book recommendations (24m10s) and his genie wish (28m10s)Michael's book recommendations (24m10s)Development Is Freedom – Amarta SenCapital Twenty First Century- Thomas PickettyGreat Expectations by Charles Dickens (first 2 pages if nothing else)Further readingWorld Medical association report- Doctors for health Look out for the Marmot review 10years on report due to be release on February 25thMichael Marmot's five recommendations of what doctors can do to tackle health inequalities1. Education2. Seeing the patient in a broader perspective/wider context3. Health service as an employer and the health system having an impact on the broader environment and community4. Working in partnership5. Advocacy See acast.com/privacy for privacy and opt-out information.

In Episode 1 of The ELSA Podcast we talk to Professor Sir Michael Marmot who helped launch the English Longitudinal Study of Ageing in 2002 about how it came about and how it can help tackle social inequality. We also hear from the study's current Principal Investigator Professor Andrew Steptoe about how the study works, how researchers can use it to better understand what happens as we age, how Government Departments use it to develop policies on pensions, loneliness and dementia and his hopes for the study's future.   

Professor Sir Michael Marmot is Professor of Epidemiology at University College London, Director of the UCL Institute of Health Equity, and Past President of the World Medical Association. 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).  Professor Marmot holds the Harvard Lown Professorship for 2014-2017 and is the recipient of the Prince Mahidol Award for Public Health 2015. He has been awarded honorary doctorates from 18 universities. Professor Marmot has led research groups on health inequalities for over 40 years. He chairs the Commission on Equity and Health Inequalities in the Americas, set up in 2015 by the World Health Organizations' Pan-American Health Organization (PAHO/ WHO).  He was Chair of the Commission on Social Determinants of Health (CSDH), which was set up by the World Health Organization in 2005, and produced the report entitled: ‘Closing the Gap in a Generation' in August 2008. Professor Marmot served as President of the British Medical Association (BMA) in 2010-2011, and is President of the British Lung Foundation.  In 2000 he was knighted by Her Majesty The Queen, for services to epidemiology and the understanding of health inequalities. Today we discuss his 2015 book The Health Gap: the challenge of an unequal world, available at Bloomsbury - https://www.bloomsbury.com/uk/the-health-gap-9781408857991/

The Swedish Global Health Podcast - A Podcast about Global Health and Sustainable Development is aimed at anyone interested in knowing more about this exciting topic! It is co-produced by the Swedish Society of Medicine's Committee for Global Health and the Swedish Society of Medicine's student and junior doctor section. The first episode consists of two parts. In the first part of Episode 1, we interview Sir Michael Marmot, Professor of Epidemiology and Public Health at University College London about the current state of Global Health, with special focus on Health Equity.

The Swedish Global Health Podcast - A Podcast about Global Health and Sustainable Development is aimed at anyone interested in knowing more about this exciting topic! It is co-produced by the Swedish Society of Medicine's Committee for Global Health and the Swedish Society of Medicine's student and junior doctor section. The first episode consists of two parts. In the second part of Episode 1, we interview Rt Hon Helen Clark, former Prime Minister of New Zealand and Administrator of the United Nations Development Programme, and Sir Michael Marmot, Professor of Epidemiology and Public Health at University College London, about collaboration between public health experts and politicians, evidence driven policy, gender equality and the way forward for global health.

"The conditions in which people are born, grow, live, work and age are vital to develop healthy lives. Action on the social determinants of health are necessary in achieving an equitable distribution of health:" Sir Michael Marmot Part of January's Value of Happy series, this Speakers' Event explores why where you live matters and the case for living longer. Join Sir Michael Marmot, Professor of Epidemiology at University College London, in discussion with Dr Julian Baggini (co-founder of The Philosophers' Magazine and author of How the World Thinks: A Global History of Philosophy) on the importance of our environment when it comes to our happiness and being disease-free. Author of The Health Gap: the challenge of an unequal world and Status Syndrome: how your place on the social gradient directly affects your health (both Bloomsbury), Professor Marmot held the Harvard Lown Professorship for 2014-2017 and is the recipient of the Prince Mahidol Award for Public Health 2015. He has been awarded honorary doctorates from 18 universities. Marmot has led research groups on health inequalities for over 40 years. He chairs the Commission on Equity and Health Inequalities in the Americas, set up in 2015 by the World Health Organizations’ Pan-American Health Organization (PAHO/ WHO). He was Chair of the Commission on Social Determinants of Health (CSDH), which was set up by the World Health Organization in 2005, and produced the report entitled: ‘Closing the Gap in a Generation’ in August 2008. At the request of the British Government, he conducted the Strategic Review of Health Inequalities in England post 2010, which published its report 'Fair Society, Healthy Lives' in February 2010. This was followed by the European Review of Social Determinants of Health and the Health Divide, for WHO Euro in 2014. He chaired the Breast Screening Review for the NHS National Cancer Action Team and was a member of The Lancet-University of Oslo Commission on Global Governance for Health. Dr Julian Baggini is the author, co-author or editor of over 20 books including How The World Thinks, The Virtues of the Table, The Ego Trick, Freedom Regained (all Granta) and The Edge of Reason (Yale University Press). He was the founding editor of The Philosophers’ Magazine and has written for numerous newspapers and magazines, as well as for the think tanks The Institute of Public Policy Research, Demos and Counterpoint. He is an Honorary Research Fellow at the University of Kent. His website is www.microphilosophy.net.

In 2008, a Commission reporting to the World Health Organization on the social determinants of health put a bold claim on its front page: ‘Social injustice is killing on a grand scale.’ “It wasn't just a slogan” Professor Sir Michael Marmot, the chair of that WHO Commission, tells us: “that was based on the evidence and the urgency that I felt then and still feel”. Sir Michael is Professor of Epidemiology and Public Health at University College London. He has made it his life’s work to understand and tackle social inequality and how it impacts on our health. He’s served as President of both the British Medical Association and the World Medical Association and also wrote the Marmot Review into health inequalities in England in 2010 - a review he is due to revisit next year; ten years on. As a member of The Bevan Commission, Sir Michael, advises Welsh Government and others on health and social care policy. “Wales has always struck me as a conundrum. The health statistics in Wales look dreadful. The inequalities are getting bigger in life expectancy and healthy life expectancy (but) the people I talked to in Wales are terrific. There is a lot of committed people in Wales who I think are ready and willing to act.”In this podcast, Sir Michael talks about his work and how the creation of ‘Marmot Cities’ around the world - place a commitment to turning the tide on social inequality and give him hope for the future: “I think we need to look at where we're heading and where we're heading potentially is for the better.”Chair of Life Sciences Hub Wales, Professor Sir Mansel Aylward, presents this episode of Healthy Thinking.

In this episode Professor Sir Michael Marmot, Professor of Epidemiology and Public Health talks about Society and Health. Visit [https://www.rsm.ac.uk/resources/podcasts/](https://www.rsm.ac.uk/resources/podcasts/) for more content.

Sir Michael Marmot, past President, British Medical Association, Chair of the World Health Organization’s commission on the Social Determinants of Health (SDOH) joins us to discuss his seminal research. Released on the 70th anniversary of the founding of the UK’s National Health Service. We discuss the changing roles and targets of governments in creating better health, not simply care, and ...

The higher you rank on the socioeconomic ladder, the better your health, and consequently the longer you can expect to live. That's according to Sir Michael Marmot, Professor of Epidemiology and Public Health at University College London, who was invited to RACS’ 2018 Annual Scientific Congress in Sydney to discuss inequalities in the developing world. Sir Michael, for years a leading researcher on health inequality, insists some of the biggest inequities occur in the world's richest nations, including Australia.

​In this episode we covered the Boyer Lecture 2016 at the ABC with Professor Sir Michael Marmot, marriage plebiscites and other perhaps more financially sound alternatives as well as the inconsistencies of the lock out laws and who they apply to. It was jam packed and that was before my interview with Tamer Morris from Normanhurst Uniting Church who is directing their production of The Importance of Being Earnest. Check it out - all proceeds go to The Dish, a support service feeding the homeless in our local area.

Prof Sir Marmot speaks with ecancertv at IARC 2016 about the challenges facing healthcare as a result of systematic inequality on a national and international scale. He discusses the impact on life expectancy between and within countries depending on lifestyle and access to care, and the importance of stemming health issues early in life with upstream interventions for public and practitioners. Prof Sir Marmot sets out five goals in practice for medical professionals: Sharing of education Awareness of patients in broader perspectives Engagement with healthcare systems as employers Wider partnership with service providers Advocacy for changes

Sir Michael Marmot joins an expert panel to discusses the conclusions of his latest book, The Health Gap, on what the government should being doing to tackle the health inequality problem

Professor Sir Michael Marmot delivers the inaugural Windsor Ethics Lecture. Cumberland Lodge www.cumberlandlodge.ac.uk is the home of an educational charity, founded in 1947 to promote ethical discussion and cross-disciplinary collaboration Registered charity: 1108677

Alcohol Alert, November 2014: This edition features an interview with acclaimed public health expert Professor Sir Michael Marmot, who gives his thoughts on the new IAS report "Alcohol, health inequalities and the harm paradox" (http://bit.ly/alcoholharmparadox). By subscribing to our enewsletter, you can receive alcohol-related stories and media directly to your inbox; please visit our website www.ias.org.uk and click on "Alcohol Alert" to read the latest Issue: http://www.ias.org.uk/What-we-do/Alcohol-Alert.aspx

Professor Sir Michael Marmot is interviewed by Kirsty Young for Desert Island Discs. He's an epidemiologist who has spent his career studying what the key factors are in leading a long and healthy life and how your income and post code can affect your longevity. Professor of Epidemiology and Public Health and Director of the Institute of Health Equity at University College London, Sir Michael specialises in what are known as the social determinants of health: how where we are in the wealth and status pecking order directly influences our chances of illness, disease and lifespan. Why is it, for example, that in 2014 in the same British city the average life expectancy for a man in one post code will be 82 but just a few miles away it's 54? His work has influenced politicians around the globe. His pioneering research is often at odds with wider societal concerns over what are known these days as lifestyle choices - like smoking, not taking any exercise or eating junk ... he says simply "what I contribute to the policy debate is that I bring evidence - I don't do the skulduggery of politics.".

Professor Sir Michael Marmot is interviewed by Kirsty Young for Desert Island Discs. He's an epidemiologist who has spent his career studying what the key factors are in leading a long and healthy life and how your income and post code can affect your longevity. Professor of Epidemiology and Public Health and Director of the Institute of Health Equity at University College London, Sir Michael specialises in what are known as the social determinants of health: how where we are in the wealth and status pecking order directly influences our chances of illness, disease and lifespan. Why is it, for example, that in 2014 in the same British city the average life expectancy for a man in one post code will be 82 but just a few miles away it's 54? His work has influenced politicians around the globe. His pioneering research is often at odds with wider societal concerns over what are known these days as lifestyle choices - like smoking, not taking any exercise or eating junk ... he says simply "what I contribute to the policy debate is that I bring evidence - I don't do the skulduggery of politics.".

Sir Michael Marmot delivers the opening lecture of the BBC Radio 3 Free Thinking Festival 2013, exploring the traits that determine a healthy life span and arguing that we need to rethink the relationship between health, wealth and self-control. Professor Marmot is one of the global pioneers of research into health inequalities - how stress, status and diet can affect our wellbeing. His ground-breaking Whitehall Studies followed the health and stress levels of British civil servants over a decade and he coined the term "status syndrome" to describe his discovery that being lower down the pecking order leads to a shorter life span. Recorded on Friday 25 October 2013 in front of a live audience at Sage Gateshead.

In Britain, the health gap is growing - in the wealthiest parts of the country, people are living on average more than a decade longer than in the poorest parts. An academic discipline which tries to work out why this health gap exists has also grown. It's called social epidemiology. You've probably never heard of it, but the science has influenced governments of both the left and right. So what answers has it thrown up? The most famous comes from the Whitehall II study of civil servants, led by Sir Michael Marmot, which found that people who are in high-pressure jobs, over which they have low control, are at greater risk of heart disease, because of the stress their lowly position causes. The idea that how much control you have over your work and life affects your health has generated talk in policy-making circles about the need to empower people. But the evidence is contested. When economists look at the same data, they see something different. David Aaronovitch hears the arguments. Contributors: Sir Michael Marmot, professor of epidemiology and public health at University College London Anna Coote, former UK health commissioner Danny Dorling, professor of human geography at the University of Sheffield George Davey-Smith, professor of clinical epidemiology at Bristol University Johan Mackenbach, chair of the department of public health at Erasmus University, Rotterdam Angus Deaton, professor of economics and international affairs at Princeton University Producer: Ruth Alexander.

Varför löper en vaktmästare större risk att dö än en chef i samma jobbkorridor? Och varför kommer den ekonomiska krisen i Europa att göra många människor sjuka? Vetenskapsradion Forum Special handlar idag om hur sociala faktorer påverkar vår hälsa - och att var vi bor, hur mycket vi studerat och vad vi arbetar med faktiskt kan förlänga eller förkorta livet. Sir Michael Marmot, världsledande expert på folkhälsa, menar att politikerna bör ta sitt ansvar och minska klyftorna i samhället- eftersom detta bevisligen räddar liv. I Sverige finns också stora skillnader i hälsa mellan olika grupper - i Malmö skiljer det sju år i medellivsslängd mellan vissa stadsdelar. Där ser man nu över vad som kan göras för att förbättra situationen - men ännu har ingen utredning på nationell nivå gjorts, vilket Denny Vågerö, professor i medicinsk sociologi, är mycket kritisk till.

When Professor Sir Michael Marmot was a junior doctor he decided that medicine was failed prevention. To really understand disease you have to look at the society people live in. His major scientific discovery came from following the health of British civil servants over many years. The Whitehall studies, as they're known, challenged the myth about executive stress and instead revealed that, far from being 'tough at the top', it was in fact much tougher for those lower down the pecking order. This wasn't just a matter of rich or poor, or even social class. What Marmot showed was the lower your status at work, the shorter your lifespan. Mortality rates were three times higher for those at the bottom than for those at the top. The unpleasant truth is that your boss will live longer than you. What's more, this social gradient of health, or what he calls Status Syndrome, isn't confined to civil servants or to the UK but is a global phenomenon. In conversation with Jim Al-Khalili Michael Marmot reveals what inspires and motivates his work. Producer: Geraldine Fitzgerald.

Sir Michael Marmot, PhD, talks about a fair society in leading healthy lives, one of a series of lectures from The Yale School of Medicine Bicentennial Symposium, "Biomedicine in the New Century," which took place over April 28-29, 2011.