Why do health inequalities exist?

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Description: Clear health inequalities exist within countries, with the consequence that more socioeconomically advantaged individuals live longer than disadvantaged individuals. This difference in longevity is partly driven by differences in behaviour, in that more advantaged people tend to adopt healthier lifestyles (less smoking, more exercise, healthier diets). But what explains these differences in behaviour? Informed by an evolutionary perspective, evidence will be presented in this talk that variation in environmental factors is associated with variation in behaviour in the UK: in ‘harsh’ environments (such as those experienced by disadvantaged individuals), behaviour will shift to become more present-oriented and less focused on the future; whereas in more ‘benign’ environments, individuals will be more likely to prioritise health in the long-term. This evolutionary perspective results in a compassionate approach to public health which focuses on changing features of the environment, rather than on individual behaviour change, as the solution to public health concerns. Such public health approaches which focus on environmental change have been described as ‘Jedi public health’ by the sociologist Arline Geronimus.

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