“And only if we can listen to each other and understand and learn from each other, bring those things together, then we will make the societal progress to tackle the health inequalities.”
Interview with Clive Needle, Senior Policy Advisor, EuroHealtNet
after the Forum on Health Inequalities with the lecture of Sir Michael Marmot
We are talking after a very important session on the topic that has been discussed for years – health inequalities. However, despite the discussions, the health inequalities are growing around the Europe. What do you think is the reason, and what can we do about it?
CN: It is a mix of factors, it is obviously a complex set of issues that you put together, it is like building a jigsaw. A part of that is lack of political will, but I think it is too easy to put all the blame on the politicians. Political is personal, which means we can all do something, we should all take the responsibility to break down that complexity.
Public health and health care practitioners, as well as policy makers and professionals all have a role to play, but there are social and economic factors underlying it. We have seen big progress in terms of understanding which data and which knowledge is needed, which brought about improvements in many areas, e.g. thanks to the Healthy Cities movement. This week in Gastein, we have heard the stories from mayors, communities and civil society, which have achieved process, but we still need to tackle social and economic injustice. This means we need to reach out, understand the reality of lives of people, and then make sure that we act across the range of factors. Only then will we be able to put together this jigsaw.
How should we talk with those who do not believe in social justice? There are plenty of politicians out there who do not share the same values?
CN: There are always ways of negotiation and compromising. Politics is all about negotiation, and if what I am saying is difficult to implement within market economies, a lot of the lessons that are viable within politics, apply equally within the business communities. Think about the most important organ you would use in advocating and persuading? People will probably say: use your mouth, your tongue. But it is ears! It is listening, and it is understanding. In business, it is understanding what the customer needs are, and adapting according to the market conditions.
And we should think about it in the same way – it is not just about designing things for the people, but also involving people in design and implementation. It is the fundamental rule. I have heard it in Gastein: “how do we better involve people?” But yet, we don’t! We are just saying: “here is this project”, and then we are surprised it is not working. It might be for cultural, social, or economic reasons, but the main problem is that we do not listen properly, and we do not involve people.
Can you give some example?
CN: Take the young people who feel so excluded right now. Engaging them in our work might have huge impact in terms of e.g. youth unemployment. Sir Michael Marmot says that youth unemployment is a public health priority. Why isn’t that at the top of the agenda? We talk theories, we “talk the talk”, we don’t “walk the walk”.
Thanks to the work of people like Sir Michael Marmot and whole public health community, we can better understand why health inequalities are such an important issue. At the session, I was sitting with a colleague who was trained as a nurse, not a long time ago. I asked her: “Did they told you about it in school?” She said: “No”. She did not know about health inequalities, she had not heard about Sir Michael Marmot before. Do you think there is a gap in the training of health professionals, and that maybe the information could go through the health system better?
CN: I have been to universities and taught about advocacy at Master’s courses. The president of EuroHealthNet, Nicoline Tamsma, is teaching about working with Master’s professionals. There is certainly a lot of work to do, to go through the systematic training with people who work in health care and public health.
The Royal Society of Health in London has done a great work talking about the “wider health force”. One of the things they say is that we have a stream of people that come through into health-related disciplines with science backgrounds. That’s great and important, because we need them to get the proper evidence and research, but we also need to work with people who come from arts and humanities backgrounds. The subtext of this conference is about politics. There are many people in politics who come from art and humanities. And only if we can listen to each other, and understand and learn from each other, bring those things together, then we will make the societal progress to tackle the health inequalities.
You said that young people should be involved in this work on health inequalities. I represent the Young Forum Gastein. What would be your advice to the young public health professionals on tackling health inequalities? How would you see our role in this process?
CN: First of all, don’t get too cynical! Keep your enthusiasm, use your ears, listen and learn, and use the opportunity of this wider world and new technologies to reach out beyond your own experience. Look what can be done. There are fantastic opportunities, and you should think not only what you can gain from it, but also what you can contribute. What part you would be able to play to make the world better. As I said, the personal is political, and all of us are politicians in some way. Let’s turn the ‘politics’ from being a dirty word into a good word, where we join to build the new formats, where we don’t have to fall back on old structures, old institutions, where we can do new exciting things. I am really excited about the opportunities to listen and learn from the young people, and see how we can support you. We don’t just need you to look after us in old age, it’s the other way around – we need to be really supportive during the life course, as intergenerational solidarity is the most important here.
Thank you for your time!
This Interview was written by the Young Gasteiner Karolina Mackiewicz