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The price of being well

Aug 28th 2008 | NEW YORK
From The Economist print edition

Is it time for a new paradigm for health and development? A heavyweight panel with an egalitarian ideology claims to have found one

“SOCIAL justice is a matter of life and death.” Thus begins a long, provocative report released on August 28th by a group of grandees with an impressive range of expertise in health and development. The pundits, who include Amartya Sen, an Indian-born economist and Nobel laureate, were asked by the World Health Organisation (WHO) to take a broad look at the question of inequality and health. After more than two years’ work, the panel has issued a call to arms with a sonorous title: “Closing the gap in a generation”.

Which gap, exactly? That the life of a slum dweller in Caracas is generally shorter, nastier and more brutish than the earthly span of a rich person in Cologne or Chicago is hardly surprising. But why, asks the panel, do men born in Calton, a rough part of Glasgow, tend to die more than two decades sooner (see chart below) than men from the dormitory town of Lenzie a few miles away? Why do America’s Asian females live, on average, to 87, while the life expectancy of black males is only 69? The explanation, according to the WHO’s Commission on Social Determinants of Health, is not merely a matter of income. Nor can it be reduced to the varying capacities of health systems. In addition to those factors, says the report, there are social, political and economic forces that ostensibly have little to do with health but can still end up determining “whether a child can grow up and develop to its full potential and live a flourishing life, or whether its life will be blighted.”沪江雅思

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