wcpt congress: event of a lifetime - World Confederation for Physical ...

HEALTH AND DISABILITY
Developments in the health
and disability sector
Health Equity:
the Marmot symposium
Karen and I were fortunate to attend
the Marmot symposium in Wellington
in July, the key speaker being
Sir Michael Marmot who has led a
research group on health inequalities
for the past 30 years.
His two landmark publications are the
2008 WHO report ‘Closing the gap in
a generation: Health equity through
action on the social determinants of
health’ and the 2010 review in England
‘Fair Society, Healthy Lives’ following
an independent review into health
inequalities in England.
The seminar was opened by the Hon
Tony Ryall, Minister of Health who gave
a brief overview of the government
health strategy. Unfortunately he had
to leave following his presentation,
thus missing the wide-ranging
presentations and discussions during
the afternoon.
The seminar and Sir Michael’s visit were
jointly sponsored by the New Zealand
Medical Association to coincide with
the release of their position statement
on “Health Equity” available on http://
www.nzma.org.nz/sites/all/files/
HealthEquity.pdf. Dr Don Simmers from
the NZMA talked about its inception
giving graphic examples of health
inequalities from two areas he had
worked, Queenstown and the suburb
of Newtown in Wellington.
All of his points (listed right) were aptly
demonstrated with examples from
the UK and around the world. The
next session involved six New Zealand
speakers whose research supported
the messages Sir Michael had made,
providing New Zealand examples.
• Professor Philippa Howden-Chapman
on her ground-breaking work into
housing and health inequality in
New Zealand
• Economist Professor Don Matheson
bemoaning our obsession with
growing GDP and our habit of
continually comparing our growth to
that of Australia
• Associate Professor Paparangi Reid
on the ongoing effects of colonialism
on health inequalities for Maori
• A Pacific perspective by Dr Debbie
Ryan and Dr Ineke Meredith who
discussed the success of pacific
island health initiatives
• Dr Russell Willis, Commissioner for
Children who talked of the
importance of children’s health
as a national priority and the recent
progress on immunisation rates and
the B4 School checks
• Professor Norman Sharpe from the
Heart Foundation on our appalling
rate of rheumatic fever, generally
caused by poor housing
• Michael Chen-Xu from the Medical
Students Association who gave an
impassioned speech on the need
for change otherwise their generation
would not be able to deliver
equitable and effective healthcare.
It was a thought-provoking afternoon,
challenging everyone to do things
differently in the future.
Powerpoints of all presentations are on
http://www.uow.otago.ac.nz/academic/
dph/research/HIRP/index.html
There is a related NZMJ editorial
- Blakely T, Simmers D, Sharpe
N. New Zealand Medical Journal,
2011;124(1338) on Inequities in
Health and the Marmot Symposia:
time for a stocktake.
Janet Copeland
Policy and Research Advisor
The key messages from Sir Michael’s presentation were:
1. Reducing health inequalities is a matter of fairness and social justice
2. There is a social gradient in health – the worse a person’s social position,
the worse his or her health
3. Focusing solely on the most disadvantaged will not reduce health
inequalities sufficiently – action must be universal but with a scale and
intensity proportionate to the level of disadvantage
4. Action taken to reduce health inequalities will benefit society in many ways
5. Economic growth is not the most important measure of a country’s success
6. Reducing health inequalities will require action on six policy objectives:
- Give every child the best start in life
- Enable everyone to maximise their capabilities and have control
over their lives
- Create fair employment and good work for all
- Ensure healthy standards of living for all
- Create healthy and sustainable communities
- Strengthen the role and impact of health prevention
7. Delivering these objectives will require action from everyone from
the government down
8. Effective local delivery requires effective participatory decision making
at local level
10 | PHYSIO MATTERS AUGUST 2011