One of the most intractable challenges of our time is to reduce the inequalities in health that exist in the United States and globally. It is also one of the greatest opportunities for improving health for everyone. In some of our past issues of Berkeley Health, we have focused on what the School is doing to reduce global health inequalities. This issue focuses on what we are doing in our own backyard.
Consistent with our history of being thought and action leaders, we were among the first schools of public health in the United States to emphasize the broad-based underlying social and environmental determinants of health. In fact, it is widely recognized that the field of social epidemiology was invented at Berkeley under the leadership of Professor Leonard Syme. Among the luminaries contributing to this field are Berkeley alumni Sir Michael Marmot at University College, London; Lisa Berkman and Nancy Krieger, now at Harvard University; and many others. Sir Marmot’s path-breaking work on British civil servant workers demonstrating better health at every higher step of the civil service ladder regardless of other factors represents one of the most seminal contributions to the field. Professor Berkman is an internationally recognized social epidemiologist who has identified the important role that social networks play in predicting declines in physical and cognitive functioning. Professor Krieger is a leader in developing theoretical frameworks that guide our understanding of the social determinants of health.
As you will read on the pages that follow, a new cohort of Berkeley scholars, using sophisticated methods and refined theories, is producing the knowledge needed to reduce the health inequalities that exist by race, ethnicity, and socioeconomic status. They are building on the work of the pioneers.
So much of our health is determined by where we live. Tell me your zip code—or the zip code of where you lived during most of your developing years—and I will tell you your current and likely future health status and life expectancy. For example, it is not by chance that there is a 10 year difference in life expectancy between the Hunters Point area of San Francisco and the more affluent neighborhoods of the city; between sections of Richmond and the rest of Contra Costa County; or between the flats and the hills of Oakland. We have third-world health statistics in nearby communities.
At Berkeley, we have a tradition of speaking out when we think things are unfair or wrong. We view social justice as a cornerstone of public health. Our faculty, alumni, and students are passionate about “closing the health gap.” As I noted in my introductory remarks to our graduating class of 2012, “Addressing these inequalities will require bold new forms of leadership. Leaders that cross boundaries between traditional public health and the education, transportation, housing, and other sectors that are so vitally important to producing healthier communities in which individuals can flourish.”
The pages that follow will give you some idea of the cross-boundary leadership of our faculty, alumni, and students that is striking at the heart of eliminating health inequalities. Working together, we recover the notion of the “commons”— what belongs to and is shared by all of us and is not the property of any of us alone. Good health is the property of the commons to which everyone should have access because we all benefit collectively. It helps create what the Commons Movement describes as “a world that works for everyone.” It is our responsibility to help lead the way.
Stephen M. Shortell PhD, MPH, MBA
Dean, School of Public Health
Blue Cross of California Distinguished Professor of Health Policy & Management
Professor of Organization Behavior