Socioeconomic status should be seen alongside smoking as mortality risk, say expertsBMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l1450 (Published 27 March 2019) Cite this as: BMJ 2019;364:l1450
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The conclusion of the final meeting of the LIFEPATH project (Geneva on 26-27 March) “the impact of socioeconomic circumstances on mortality is comparable to that of smoking, alcohol, and obesity” …and its perspective “(it) helped inform guidance to policy makers on how health, economic, and social policies should be developed.” deserve comment.
In 1984, Marmot showed that individuals in the lowest, relative to the highest, socio-economic status group, were 3 times more likely to die of cardiovascular diseases.(2) It is good news that: a) Marmot's hypothesis is confirmed; b) a guidance to policy makers is now available, as obviously, the Commission on Social Determinants of Health, also held in Geneva in 2008, was a complete waste of time. Thanks to the €7 259 113 funding from the European Commission.
However, the symbol may be the most important. The choice of the place for the meeting is not an innocent one, it highlighted how the wealthiest could be concerned by the most vulnerable and deprived. Not only is Geneva the capital of a country with one of the highest per capita and standards of living in the world but also the meeting was held in the Villa Louis-Jeantet (a luxurious villa in the residential area of Florissant, built in 1906 on the Italian model of patrician neo-Renaissance by Count de Franceschi for his wife).
Evidence that social determinants (poverty, education...) impact mortality and probably well-being, only goes half way. It now only remains to show evidence that fighting poverty and ignorance could be effective. These are really great times we are living in.(4)
1 Iacobucci G. Socioeconomic status should be seen alongside smoking as mortality risk, say experts. BMJ 2019;364:l1450.
2 Marmot MG, Shipley MJ, Rose G. Inequalities in death--specific explanations of a general pattern? Lancet 1984;1:1003-6.
3 Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health: Commission on Social Determinants of Health final report. World Health Organization, Geneva 2008.
4 Braillon A. Child poverty: no future? Lancet 2017;389:1882.
Competing interests: No competing interests