Far from ‘closing the gap’ in life expectancy, health inequalities in Europe have deepened further. Drawing upon his forthcoming review of health inequalities in Europe, Michael Marmotargued that social inequalities, with their impact on life expectancy, should be at the top of the public agenda and we should place fairness at the heart of decision-making for health.

Integral to Marmot’s work is the graded relationship between social deprivation and a multitude of health outcomes. He reports that male life expectancy in the Russian Federation is 20 years less than in Iceland, but also highlights “huge differences within countries” and that “the gradient is increasing”.

Alcohol use: a cause or consequence of inequality?
What is driving the social gradient in health? Panel member Christopher Gerry stressed that “Alcohol matters”, and quoting Richard Peto said: “More than half of all deaths of people of working age in Russia are caused by alcohol.” But importantly, Gerry identified alcohol as just the proximate cause: “What makes people drink in the way that they do is the real question.”

Marmot was quick to distinguish between immediate causes and the underlying psychosocial mechanisms that drive unhealthy behaviours. In the case of Russia: “Some people are utterly convinced that alcohol plays a role, the main role” in health inequalities. But he disagreed, while acknowledging its role in violent deaths.

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Shivani Singh, PhD student at the UCL Centre for International Health & Development, reports on the UCL Global Health Symposium ‘Child Maltreatment: A six-country comparison of trends’, held on 18 January.

The seminar marked the beginning of a new year of fascinating lectures hosted by the UCL Institute for Global Health.

The session was well attended and featured the work of Professor Ruth Gilbert of the UCL Institute of Child Health. Joining her as panellists were June Thoburn, Emeritus Professor from the University of East Anglia, and Richard Bartholomew, who is the joint Head of the Government Social Research service and Chief Research Officer, Children, Young People and Families Directorate, Department for Education.

The focus of Professor Gilbert’s research is to understand child maltreatment across the industrialised nations of Canada, the USA, England, Sweden, New Zealand and Australia.

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India’s human development rankings are struggling to keep up as the country rises through the per capita GDP rankings. At the UCL Lancet Lecture, Professor Jayati Ghosh set out an alternative public health-centred growth strategy to address the deepening divide. Kelly Clarke reports.

The dream
An increase in per capita income increases the amount of money available to spend on food. Governments have access to larger funds for public health programmes to improve basic health facilities, sanitation, education, housing, transport, etc, etc.

The Indian reality
Ghosh, one of the world’s leading economists, described how the Indian government is failing to synergise economic development with an improvement in basic health indicators. The reason: a lack of investment in public health.

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Back in 2000 the world committed to eight Millennium Development Goals (MGDs) to galvanize efforts to meet the needs of the world’s poorest by 2015. Although significant progress has been made, reaching all the goals continues to be challenging. As 2015 approaches, Mike Rowson (UCL Centre for International Health and Development) led an engaging UCL Institute for Global Health debate on 21 July to explore what we’ve learned from the MDGs and what the next chapter in development should look like.

From left: Lucy Scott (Overseas Development Institute), Karen Newman (Population and Sustainability Network) and Dr Meera Tiwari (University of East London). Credit: Sarah Ball

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