Marmot, Sir Michael

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Sir Michael Marmot has been at the forefront of research into health inequalities for the past 30 years. His groundbreaking research demonstrated the connections between psychosocial factors and the social gradients of disease.

Graduating in Medicine from the University of Sydney in 1968, Michael earned an MPH in 1972 and a PhD in 1975 from the University of California, Berkeley. While his postgraduate education was undertaken in the US, it has been in the UK that Michael has built his academic career.

In 1976, he became a Lecturer, then Senior Lecturer in Epidemiology at the London School of Hygiene and Tropical Medicine and in 1985, was appointed Professor of Epidemiology and Public Health at the University College London (UCL). In 1990, he was appointed to a Joint Chair at both of these institutions.

Principal investigator of the Whitehall Studies of British civil servants, Michael searched for explanations for the strikingly inverse social gradient in morbidity and mortality. While it has been known since people first looked that poverty and material deprivation were bad for health, Michael’s contribution was to show that health follows a social gradient – the lower the position in the social hierarchy, the higher the risk of bad health. In a series of detailed studies, Michael and his colleagues showed that the important gateway to health inequalities is through the brain:

Psychosocial factors, such as low control over life circumstances and little social engagement, influence neuroendocrine pathways, which in turn influence metabolism to increase risk of diabetes and heart disease. These diseases, therefore, follow a social gradient, as do mental illness and other major causes of death.

The impact of this research has been significant. Michael’s social gradient has now become of intense research interest, not only in Britain, but across Europe, in North America and Australasia. The Macarthur Foundation in the US established a research network specifically to try and answer the questions thrown up by Michael’s studies.

Research on social determinants of health has also led Michael into two new research areas. He and his colleagues have been investigating the causes of the health crisis in Central and Eastern Europe and the former Soviet Union. Collaborating with research scientists in these countries, they have shown the link between dramatic social and economic changes and health in countries undergoing transition. They have now set up three major longitudinal studies in Poland, the Czech Republic and Siberia to investigate this vitally important health issue, while also providing research training for colleagues in these countries.

Michael has also been concerned with how research is applied in policy to improve public health. To this end, he served for six years on the Royal Commission on Environmental Pollution in the United Kingdom, and has played a leading role in three other areas: nutrition, alcohol, and social determinants of health. Michael’s main focus has been in translating research findings on social inequalities in health into a form on which to base policy. At the request of the European Office of the World Health Organization, his International Centre for Health and Society produced the publication Solid Facts which laid out ten premises for the social determinants of health. It was translated into 24 European languages and has been used in policy formation in more than 30 European countries. At the request of WHO, a second edition has just been published.

In Britain, Michael served on the Independent Inquiry into Inequalities in Health (which produced the Acheson report), established to advise the British government on ways to reduce health inequalities. He now chairs the committee charged with overseeing what action has been taken to reduce health inequalities and what effect it has had.

Michael is currently Director of the International Institute for Society and Health, and was awarded a Medical Research Council Professorship in 1995. In 1989 he was elected Fellow of the Faculty of Public Health Medicine, Fellow of the Royal College of Physicians in 1996, and Fellow of the Academy of Medical Sciences at its founding in 1998.

In 2005 the World Health Organization set up an independent Commission on Social Determinants of Health with Michael as Chair. This high-level international body is seeking to influence social and health policy globally.

In 2000, he was knighted by her Majesty the Queen “for services to Epidemiology and understanding health inequalities”. In the USA he was elected to the Institute of Medicine of the National Academy of Science. He is Vice President of the Academia Europea.

Citation: Mellor, Lise (2008) Marmot, Sir Michael. Faculty of Medicine Online Museum and Archive, University of Sydney.

An alternate version appears in: Mellor, L. 150 Years, 150 Firsts: The People of the Faculty of Medicine (2006) Sydney, Sydney University Press.