Sir Michael Marmot, MBBS, MPH, PhD
Director, International Centre for Health and Society; Professor of Epidemiology and Public Health; Chairman, Commission on Social Determinants of Health; University College London

Monday, November 14, 2005 - 12:00 PM - 1:30 PM
250 Jon M. Huntsman Hall

co-sponsored with the Population Studies Center (PSC)

Paper 1: Social Determinants of Health Inequalities
Paper 2: The Influence of Income on Health

Biosketch:
Michael Marmot has been at the forefront of research into health inequalities for the past 20 years, as Principal Investigator of the Whitehall studies of British civil servants, investigating explanations for the striking inverse social gradient in morbidity and mortality. He chairs the Department of Health Scientific Reference Group on tackling health inequalities and chairs the National Institute for Clinical Excellence (NICE) Research and Development Committee. He also chairs committees of the BHF and the Wellcome Trust. He was a member of the Royal Commission on Environmental Pollution for six years. Internationally acclaimed, Marmot is a Vice President of the Academia Europaea; a member of the RAND Health Advisory Board; a Foreign Associate Member of the Institute of Medicine, and chairs the WHO Commission on Social Determinants of Health. He was awarded the Balzan Prize 2004 for Epidemiology and will give the Harveian Oration in 2006. He was Knighted by Her Majesty The Queen in 2000 for services to epidemiology and understanding health inequalities.

Marmot's research has been devoted to establishing the chain of disease causation from the social environment, through psychosocial influences, biological pathways, to risk of cardiovascular and other diseases. In studies of Japanese migrants to the USA and migrants to Britain from a number of countries, he showed that disease rates change. The longer the migrant has been in the new country, the more closely rates of disease resemble those of the new country. A specific object of investigation was the high rates of cardiovascular disease and diabetes among immigrants from the Indian subcontinent. This defied the usual explanations. Marmot showed it was related to the metabolic syndrome related to insulin resistance and the resultant lipid disturbances. This same set of biological mechanisms proved important to the inverse social gradient in cardiovascular disease in Britain. Marmot's studies of civil servants showed that the lower the status, the higher was the risk. Plasma fibrinogen and the metabolic syndrome mediate much of this excess risk. Marmot produced evidence linking low control at work to the increased risk of cardiovascular disease. He and his colleagues have good evidence that psychosocial stress pathways are involved in the metabolic disturbances observed. It is these pathways that provide the most promising explanation for the new phenomenon that they are investigating: the dramatic increase in cardiovascular disease and drop in life expectancy that occurred in Russia and other former communist countries of Central and Eastern Europe. A new thrust of the research is its application to an ageing population.



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