Michael Marmot’s book the Health gap: The challenge of an unequal world , first published in Great Britain in 2015, was recently translated in Italian by a team of researchers coordinated by Giuseppe Traversa and Simona Giampaoli from the Italian National Institute of Health (La salute disuguale – La sfida di un mondo ingiusto, Il Pensiero Scientifico, 2016).

Michael Marmot’s research activity is devoted to explain why and how social injustice can negatively affect our health. The evidence he provides shows that dramatic differences in health are not a simple matter of rich and poor; poverty alone doesn’t drive ill health, but inequality does. In every country, people at relative social disadvantage suffer health harms and shorter lives.

Within countries, the higher the social status of individuals, the better their health. Most importantly, Sir Michael Marmot also offers the recipe for change to improve social justice. The book contains a “political” interpretation of the inequality, claiming the rate of illness of a society as a consequence of its operation. A key word present all over the book is “gradient”: a health gradient acts on the whole society at different levels. Not only people with lower socio-economic status have worse health outcomes than other people, but health outcomes become worse – gradually – starting from the highest level (around 1% of the population) and descending. Yes, we all are part of the social gradient in health; also the upper and the middle classes are not immune.

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