Intended for healthcare professionals


Grenfell Tower fire: why we cannot ignore the political determinants of health

BMJ 2017; 357 doi: (Published 20 June 2017) Cite this as: BMJ 2017;357:j2966
Mental health response to disasters and other critical incidents: Free access to BMJ Best Practice topic
  1. Martin McKee, professor of European public health
  1. London School of Hygiene and Tropical Medicine, London, UK
  1. martin.mckee{at}

A public health response must confront the underlying causes

The questions began within hours of the tragedy. Could it have been foreseen? Was there a design fault? Why had the victims been concentrated among the poor and marginalised? More questions followed a few days later. How could politicians appear so insensitive in the face of such suffering? Why were so many warnings ignored? Who was responsible for the budget cuts that increasing numbers of people blamed for the disaster?

This was not London in 2017, in the aftermath of the fire in Grenfell Tower, a residential block that turned into an inferno trapping scores of people, with at least 79 people dead or missing. It was 2005, in New Orleans. The official line, repeated by President George W Bush, was that the flooding that followed Hurricane Katrina could not have been foreseen. Yet, it soon became clear that the Federal Emergency Management Agency had predicted that flood protection would be overwhelmed only four days before the event.1 Others …

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