Health

The Sewell report cited my work – just not the parts highlighting structural racism | Michael Marmot


If the authors had referred to my latest research, they would not have been so quick to dismiss this crucial factor

There has been a great deal of interest in the report of the Commission on Race and Ethnic Disparities (Cred), which reviewed pertinent evidence on discrimination in education, the labour market and elsewhere. My focus, unapologetically, is on the health chapter, which prominently cites my own work. Unfortunately, the authors of the report quote my views from the 2010 Marmot Review produced by the UCL Institute of Health Equity (IHE) – but they do not mention the explicit reference to race/inequality in two reports from our institute last year, Health Equity in England: The Marmot Review 10 Years On and Build Back Fairer: The Covid-19 Marmot Review.

I focus on health, not only because that is where Cred cites my work but because my longstanding worldview is that the level of health of the population tells us a great deal about how well a society is meeting the needs of its citizens. Inequalities in health tell us about inequalities in society. The health lens gives me a way of evaluating which inequalities in society are most salient. For example, should we care if one family lives in a bigger house than another? My approach to that difficult question is: no, we should not care, if those differences in housing do not lead to inequalities in health. But if living in an overcrowded, underheated, unaffordable dwelling leads to worse health, then we should indeed care. It means the way I evaluate the Cred report’s conclusion on the existence or otherwise of racism is whether it provides an adequate explanation of racial/ethnic health inequalities. (The report’s heading is “disparities”, but in the health chapter it sometimes lapses into the more familiar language of “inequalities”.)

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

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