Published on July 3, 2008
The Road to Health and Equality PAUL K. SIMPSON, M.D.
What can we learn from international comparisons of social inequalities in road traffic injury mortality? T H Lu, T L Chiang, and J W Lynch Inj. Prev., June 1, 2005; 11(3): 131 - 133. Transport issues faced by residents in deprived areas in urban Scotland Julian Hine, Professor of Transport, University of Belfast. Interaction between social and environmental justice Kevin Dunion, Chief Executive, Friends of the Earth. Community Safety Partnerships: Delivering the Social Justice Agenda Philip Walker, Director, Community Safety Partnership, Glasgow City Council. Inequalities in health in older people: is there cause for concern? Dr Rachael Wood & Dr Marion Bain, NHSScotland. Social Justice ...a Scotland Where Everyone Matters Annual Report 2002 ------------------------------------------------------------------------------------------------------------------------
1999 WHO STUDY OF MOBILITY CONCLUSION: EXERCISE LEVELS, SOCIAL CONTACT, AND ACCESS TO SERVICES, IN CHILDREN, THE ELDERLY, THE ILL, AND THE POOR IS INVERSELY RELATED TO THE SOCIETAL LEVEL OF MOTOR VEHICLE USAGE IN ALL COUNTRIES.
Figure 1.1: Resident Images: Ratio of Positive vs. Negative Environmental Perceptions (EP) of Residents by Street Type
Figure 1.2: Average Number of Friends per Person by Neighborhood and Street Type
San Francisco study of social contacts in third graders TRAFFIC LEVEL LIGHT MODERATE HEAVY NUMBER OF FRIENDS 3.0 1.3 0.9 NUMBER OF ACQUAINTANCES 6.3 4.1 3.1
Nature Deficit Disorder
Section 5: Mobility, Transport and Pollution “Higher traffic volumes result in feelings of insecurity, especially amongst families with children, and older people, and are associated with lower levels of non-traffic street level activity, such as walking. This can result in a community with limited potential for building or maintaining social networks.” UK Independent Inquiry into Inequalities in Health Report Chairman: Sir Donald Acheson Prepared 26 November 1998
“ Social determinants of health: a panoramic view” by Professor Michael Marmot 2004 Balzan Prize for Epidemiology STATUS SYNDROME: the linking of social status to health. “ The higher the social position, the longer can people expect to live, and the less disease can they expect to suffer.” “ Social determinants of health: a panoramic view” by Professor Michael Marmot 2004 Balzan Prize for Epidemiology
BMJ 1997;Volume 314:558-65 Low job control and risk of coronary heart disease in Whitehall II (prospective cohort) study . Bosma H, Marmot MG, Hemingway H, Nicholson AG, Brunner E, Stansfeld A. Objective: To determine the association between adverse psychosocial characteristics at work and risk of coronary heart disease among male and female civil servants Conclusion: Low control in the work environment is associated with an increased risk of future coronary heart disease among men and women employed in government offices.
Social Determinants of Health: WHO 2003
BMJ 2006;332:521-525 (4 March), doi:10.1136/bmj.38693.435301.80 Chronic stress at work and the metabolic syndrome: prospective study Tarani Chandola, senior lecturer 1, Eric Brunner, reader 1, Michael Marmot, head of group and department 1 1 Department of Epidemiology and Public Health, University College London, London WC1E 6BT Objectives To investigate the association between stress at work and the metabolic syndrome. Conclusions: A dose-response association exists between exposure to work stress and the metabolic syndrome.
American Journal of Public Health, Vol 90, Issue 1 64-69, Copyright © 2000 by American Public Health Association JOURNAL ARTICLE The effect of poverty, social inequity, and maternal education on infant mortality in Nicaragua, 1988-1993 R Pena, S Wall and LA Persson Department of Preventive Medicine, Universidad Nacional Autonoma, Leon, Nicaragua. firstname.lastname@example.org OBJECTIVES: This study assessed the effect of poverty and social inequity on infant mortality risks in Nicaragua from 1988 to 1993 and the preventive role of maternal education. CONCLUSIONS: Apart from absolute level of poverty, social inequity is an independent risk factor for infant mortality.
Pathways of Neuroendocrine Response to Stress
Figure 2. A variety of stressors experienced during pregnancy may result in lifelong alterations in autonomic and HPA axis activity in the developing fetus
Figure 1. Mean fasting total cortisol concentrations ( A ) and estimated free cortisol concentrations ( B ) in 370 men aged 65 from the Hertfordshire Cohort Study according to birthweight
Social Determinants of Health: WHO 2003
Status Syndrome Geographic Correlation LOCATION DC ------------------------------- 12 Mi. ------------------- Montgomery, MD 57-------- 59--------- 71--------- 73--------- 75----------- 76.7 LIFE EXPECTANCY (years)
Social determinants of health inequalities Michael Marmot Panel 2: The Solid Facts Because the causes of the causes are not obvious, the WHO Regional Office for Europe asked a group at University College London to summarise the evidence on the social determinants of health, published as The Solid Facts .22 It had ten messages on the social determinants of health based on: -the social gradient -stress -early life -social exclusion -work -unemployment -social support -addiction -food - transport Lancet 2005; 365: 1099–104 International Centre for Health and Society, University College London, 1–19 Torrington Place, London WC1E 6BT, UK (Prof Sir M Marmot) [email_address]
Cuba, 1991: Unplanned Transportation Equalization
BOGOTA, COLOMBIA, 1995: Planned Transportation Equalization ENRIQUE PENALOSA, Mayor 1995-2001
Recommendations Build equality promotion into all transportation systems and a make it a design feature of every project Include equality analysis as a criterion in all transportation studies Develop transportation equality metrics to standardize these studies Consider the status syndrome in all studies of transportation health effects Recognize status syndrome health damage as an externalized cost in any transport economic analysis
Build equality promotion into all transportation systems and a make it a design feature of every project
Include equality analysis as a criterion in all transportation studies
Develop transportation equality metrics to standardize these studies
Consider the status syndrome in all studies of transportation health effects
Recognize status syndrome health damage as an externalized cost in any transport economic analysis
Author Paul K. Simpson, M.D. Clinton Medical Associates 1301 East Branch Road State College, PA 16801 USA [email_address] 814-867-4266 814-574-6334 (cell)
Paul K. Simpson, M.D.
Clinton Medical Associates
1301 East Branch Road
State College, PA 16801