CITRIC PERCH DROPPING

See Also: CIVIL SERVANTS Mandarins; STEPS TO HEALTH

Sir Michael Marmot started his working life practising cardio-respiratory medicine as a junior doctor in his native Sydney. He enjoyed the immediacy of being able to cure people but he became aware that many of his patients were returning with either new complaints or recurrences of their past ones. As a result, he became interested in preventative medicine.

At a colleague's suggestion, he entered the field of epidemiology. He chose to study for a Ph.D. in the subject at the University of California Berkeley. Having been awarded the degree, Marmot opted to move to Britain. He became a member of University College s Department of Epidemiology & Public Health.¹

The Whitehall Study had been established in 1967 by Donald Reid and Geoffrey Rose to study the health of 18,000 male civil servants. Marmot became one of the project s researchers. He specialised in its social aspects. When its findings were published as Employment Grade and Coronary Heart Disease In British Civil Servants (1978) he was the article's lead author. This made clear that the lower the status of an individual was so the greater his risk of disease was. Social determinants had a clear impact upon health. He identified its correlation with social gradient from top to bottom.

In 1977 the Department of Health & Social Security had commissioned its chief scientist, the physician Professor Sir Douglas Black, to write a report on health inequalities. The Conservatives were elected to power two years later. The knight delivered his findings in 1980. Ideological considerations prompted the Thatcher government to disregard the conclusion of his report - that social injustice kills on a grand scale - because the reality did not service its political agenda. The document was issued on August Bank Holiday.

Marmot had established the Whitehall II Study, which included women civil servants in its sample group. He investigated psycho-social processes and how the mind affects the body. He progressed to matters of social policy. He called for health inequalities that were avoidable to be removed by reasonable means.

A Labour government was elected in 1997, thereby ending eighteen years of Tory rule. Overnight the status of Marmot s research switched from being pure to being applied. The epidemiologist was commissioned to write a report on health inequalities.

Marmot has gone on to work on social determinants of health internationally.

Location: The Department of Epidemiology & Public Health, University College, 1-19 Torrington Place, WC1E 6BT (purple, brown)

Whitehall, SW1A 2NS (blue, grey)

Website: https://iris.ucl.ac.uk/iris/browse/profile?upi=MGMAR64

¹. Within the world of London academic medicine, Jerry Morris became one of his mentors.

Professor Marmot's Extension

A 2001 study by the sociologist Robert Erikson of Stockholm University's Swedish Institute for Social Research revealed that in Sweden the holders of masters degrees and professional degrees tended to earn more than people who have been awarded Ph.D.s. However, the latter had lower rates of mortality because they were of a higher social gradient than the former. Therefore, Marmot had extended his own lifespan by opting to acquire a doctorate rather than just continuing to be a medical doctor since medical degrees are awarded at a masters level.

David Backhouse 2024