Synthesis Paper for “The Health Gap” by Michael Marmot

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Table of Contents

Top Ten Tips for Health
Do Something and Do More
Politics and Health
U.S. Health Report Card
Jimmy vs. Danny
The Causes of the Causes
References

Top Ten Tips for Health

Marmot’s The Health Gap: The challenges of an unequal world is a breakthrough literary work that focuses on the idea that social inequalities negatively influence one’s health. In his book, Marmot reported on two lists containing top ten tips for health, which are different in the way they approach the concept of health as well as what external or internal factors can either benefit or limit one’s health. Based on these lists, Marmot proposed his interpretation of health and provided advice such as “confront these structures: of class, gender, ethnicity […]” or “prepare for state oppression/repression […]” (Marmot, 2015, p. 50). Based on my personal experiences, I composed the following list of tips that are different from Marmot’s:

Be educated about the limitations of your society.
Share your knowledge.
Acknowledge your rights and privileges.
Help those in need of your support.
Your health is your own responsibility.
Contribute to the improvement of the health system.
Recognize the societal inequalities with regards to health.
Don’t be afraid to ask for help from others.
Develop a positive mindset: a healthy mind in a healthy body.
Be prepared for both failures and victories.

To some extent, my tips are parallel to those of Marmot in a sense that they also acknowledge the societal inequalities and include recommendations as to how one can overcome these inequalities. However, I chose to put an emphasis on personal development and self-education in the effort to become healthy. Moreover, I support the idea of a healthy mindset and practices targeted at becoming mentally balanced; in my opinion, a positive outlook on health can make a tremendous difference.

Do Something and Do More

It is the responsibility of a nurse to try to “do more” with regards to the established duties. Apart from providing a high level of health care, I would like to become an educator for those people that do not take their health seriously. An educated society that understands the main principles of a healthy lifestyle will be prosperous and able to implement change faster and more effectively. As a nurse, I would like to organize and participate in public events targeted at raising awareness of the key health problems our society faces and to teach people how they can take control of their health. Leading by example can also become a successful practice, so I should be actively involved in my personal health.

Politics and Health

According to Marmot (2015), “society and health, by its nature, is a highly political issue” (p. 15), and I cannot agree more. Inequalities that exist in the healthcare system can be eliminated through implementing political change. The provision of free healthcare for all citizens is a change that can potentially decrease the inequalities within the system. As a nurse, I should develop strong leadership skills to make changes in the health care system.

In collaboration with other health care professionals, I can participate in public events and forums to discuss the advantages and difficulties of the change in order to come to a mutual conclusion about how the change should be implemented by the local, state, and federal governments. Undoubtedly, the change will have an impact on taxpayers; however, no price should be put on the health of our society. If we make changes now, the future generations will thank us for it.

U.S. Health Report Card

Personally, I agree with the statement that health is a good measure for determining how we, as a society, are doing. In order to assess the key points of society’s health, it is important to define the concept of society. In this context, society is defined as a large community of people that share a culture, traditions, common institutions, collective interests, and common practices. When it comes to defining “we,” the concept refers to various groups in the society that share a common interest of achieving a certain goal. For example, when it comes to implementing change in the sphere of healthcare, not every member of society will be willing to participate; thus, I choose to define “we” as those people that are active enough to attempt implementing change. In order to assess how the American society is doing, I developed a report card, which is presented below:

Success in eliminating the cases of preventable death	D
Reduction of health insurance waste	C-
Saving Medicare costs by reducing the rate of preventable hospitalizations	B
Provision of preventive care	C
Reduction of childhood obesity and the promotion of a healthy lifestyle for children	B
The provision of adequate sexual education targeted at raising awareness of sexually transmitted diseases and the reduction of unwanted pregnancies	C-
Cardiovascular disease control and prevention	D
Equal treatment of all patients regardless of their income or background	D
Healthy lifestyle: reduction of smokers in the nation, healthy diet, physical exercise, etc.	F

Jimmy vs. Danny

Analyzing Jimmy’s irresponsible and often self-destructing behaviors, Marmot came to a conclusion that this man’s inability to make rational and wise decisions in regard to his own life was based on his troubled childhood experiences. In other words, according to Marmot’s perspective, all of the problems Jimmy experienced were linked to his background of living in poverty and being abused as a child: His mother had a “succession of male partners, most of whom abused Jimmy physically, if not sexually” (Marmot, 2015, p. 91).

Differently put, the man has never been taught how to take care of himself but received multiple experiences of abuse and neglect making these emotional states his “comfort zone”. In that way, Jimmy simply did not know what it was like to be happy and healthy or how to make himself happy and healthy; at the same time, the only life he knew was that driven by suffering.

Another description of a “troubled” individual was given in Younge’s (2016) book, Another Day in the Death of America. In this case, the behavior of Danny was triggered by an idea rather than a random spurt of brain chemicals or a stimulus (Younge, 2016). Such an explanation of violent actions is contrary to those provided by Marmot. Younge mentioned the amok men of Papua New Guinea, whose extremely low self-image led to an idea of self-rehabilitation in the eyes of their community by causing harm to a group of innocent and more valuable people.

In the latter theory, the psyche of a troubled and deeply unhappy individual pushed him to project his inner pain and frustration on others, whereas in Marmot’s understanding the internal damage resulted mainly in a self-harm pattern. Also, the actions of Jimmy are described as unconscious whereas those of Danny present a rational choice. I agree with both of the theories and views and believe that such manifestations of inner pain and fear can occur in different individuals depending on their personalities and the external stimuli driving certain behaviors.

The Causes of the Causes

Marmot argued that the society should go beyond the typical interpretation of the causes of bad health (e.g., bad diet, smoking, drinking, etc.) and learn to understand the “causes of the causes.” In his view, these causes refer to the social determinants of ill or good health, and they have an impact on not only physical wellbeing but also on an individual level of stress in different environments. The causes of the causes, according to Marmot (2015), include absolute poverty; however, the level of inequality within the health care system, as well as the “nature of society,” are far more important when it comes to people becoming healthier (p. 23).

For example, the nature of the Swedish society is egalitarian, where any boasting of wealth is frowned upon. Therefore, the treatment of health and wellbeing in the country is also based on the principle of egalitarianism, where the wealthy have the same access to healthcare as those that make minimum wage. The cause of the causes, for the Swedish society, will be egalitarianism, which rules every aspect of societal life, so there is a tremendous gap between the health outcomes of the U.S. and Sweden. Such a gap is traced in the health statistics; for example, the diagram below (Figure 1) shows infant mortality rates in the U.S. compared to some European countries (including Sweden):

Figure 1. Infant mortality in the U.S. vs. Europe (“Infant mortality rates,” n.d.).

In such cases, facts speak for themselves; the nature of the society has a tremendous impact on the health of the nation and plays the role of the “cause of the causes.”

References

Infant mortality rates. (n.d.). Web.

Marmot, M. (2015). The health gap: The challenges of an unequal world. London, UK: Bloomsbury.

Younge, G. (2016). Another day in the death of America: A chronicle of ten short lives. New York, NY: Nation Books.

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