Rising up with shoe leather? A comment on Fair Society, Healthy Lives (the Marmot Review).

Fair Societies, Healthy Lives (Marmot Review, 2010), the final report of the Marmot Review on health inequalities in England, begins by quoting Pablo Neruda: “Rise up with me against the organization of misery” (p. 2). This passionate call to arms seems well-suited for a treatise that promises cures to some of society’s greatest ills. Commissioned by the British Secretary of State for Health, the Review is charged with consolidating the evidence on health inequalities and developing evidence-based policy proposals to reduce them. In this commentary, we discuss the Review and its prescriptions from the perspective of economists who are interested in using research to inform the design of better public policy. TheReviewbeginswith anoverviewof the relationships between health and various measures of social standing, also known as the social gradient in health. These include the traditional domains of education, income and employment, as well as less-known topics such as work control and neighborhood social capital. The Review also pays special attention to the role of early-life circumstance in shaping the social gradient in health. Health inequalities, the Review contends, arise because of social inequalities, so efforts to reduce health inequalities must start with action in the social sphere. Economists will find this descriptive enterprise of enormous importance. Yet a vast majority of this research remains