Investing in Health to Improve the Wellbeing of the Disadvantaged: Reversing the Augment of the Marmot Reports

The Marmot reports have argued that health inequalities are the result of social inequalities. They advocate reducing health inequalities by undertaking fundamental changes that make society fairer. We argue that the focus should be on improving the health and wellbeing of the disadvantaged, even if the policies that do this also raise the health of the better off, and worsen inequality. We also argue that the causality runs from health to social status, and that health interventions are needed to improve socioeconomic outcomes. While we disagree on goals and mechanisms we are in surprisingly close agreement with Marmot Reports on policies. In particular, we agree with the focus on in early childhood investments in health and physical and cognitive development that have long term socioeconomic payoffs. We also endorse making society fairer, though mainly as a goal in itself rather than an instrument to reduce health inequality.