Danny Dorling is professor of geography at Oxford University. This book is a collection of articles showing his view, as a geographer, on the social determinants of health. His thesis is that greater social inequality in a country (largely income inequality) is positively correlated with poorer health outcomes.
This is not simply due to increased poverty. Health outcomes are worse for the rich as well. In recent years inequality has increased in the UK, as a ‘greed is good’ culture has taken hold. The welfare state hasn’t compensated for the adverse effects and this book does offer some fascinating insights. I especially enjoyed the piece about the life expectancy you lose by smoking a cigarette (calculated at 11 minutes). This edition is largely a collection of work previously published elsewhere, some as long ago as 2000, and much is available online. There are around 30 000 new words and as might be expected from an academic geographer, there are many maps and tables. Sadly, these are difficult to interpret and the colour versions, included in a plates section, are too small (they are available at Worldmapper.org or at dannydorling.org and are better on screen).
Although it’s useful to have all these articles together, the subject of inequality and health was, in my opinion, addressed better in Dorling’s previous book Injustice. I wasn’t sure who this book was for; perhaps for the training practice library to remind registrars and their elders about determinants of health other than medicine?
There is one further curiosity. In a chapter about distortion of data in graphs there is an illustration of Hans Holbein’s painting The Ambassadors which, famously, includes a distorted skull. There is no explanation as to why the picture is there.
If you are interested, there are good lectures on Youtube from Canal Educatif 1 or John Berger’s Ways of Seeing 2 that beautifully illustrate how a different viewpoint can lead to different conclusions.
- © British Journal of General Practice 2014