Inequalities in Health Michael Marmot, Ph.D / New England Journal of Medicine, v.345, n.2 12jul01

Inequalities in Health Michael Marmot, Ph.D / New England Journal of Medicine, v.345, n.2 12jul01:
"Geographic variations in health within rich countries arc substantial. White men in the 10 'healthiest' counties in the United States have a life expectancy above 76.4 years. Black men in the 10 least healthy counties have a life expectancy of 61 years in Philadelphia, 60 in Baltimore and New York, and 57.9 in the District of Columbia.2 The 20-year gap in life expectancy between whites in the healthiest counties and blacks in the least healthy is as big as differences between countries at very different stages of economic development. The best off are like Japan; the worst off hover around the level of Kazakhstan and Bangladesh.3 The low life expectancy in poor countries may be the result of starvation, infected water, and poor sanitation. The low life expectancy of people who live in poor areas within rich countries is not. The major contributors to excess deaths among men in Harlem are circulatory disease, homicide, and infection with the human immunodeficiency virus.4"