by Dr John Middleton, Vice President, Faculty of Public Health
One of my daughters gave me a copy of How to Be a Woman for Christmas. “Every man should read it”, so the blurb goes. Yet in these musings of a contemporary Black Country wench is evidence of just how much further there is to go for women to achieve equality, rights and health. It is not just the glass ceiling that aspiring women face that should exercise us, but the gross inequalities women face in global society.
Women are more likely to be poor and in low-paid, unskilled occupations. According to the Organisation for Economic Co-operation and Development and United Nations reports at the turn of the year, women perform 66% of the world’s work, produce half the food, earn 10% of the income and own 1% of the property. Women’s educational achievement will be at least as good as men’s but they are far less likely to have opportunities for advancement generation on generation, mother to daughter.
Over Christmas, “Victorian” has been much in evidence as a descriptor of UK public health – whether in relation to the rise in tuberculosis, the gin-factory fire in Sandwell, soup kitchens, rough sleepers and the undeserving poor. “Biblical” has been used to describe the unfolding horror and public health disaster of Syria. “Dark ages” has been used to describe the carnage of Newtown, the massacre of polio vaccination workers and the gang rape of Delhi.
In the field of crime it should be obvious that blaming the victim is unacceptable, and yet it goes on: the school didn’t protect itself; the rape victim was wrongly dressed. In public health the powerful and comfortable are renewing their assault on the victims of their health-destroying policies: John Redwood says the poor are to blame for the growth of betting shops; David Cameron praises the food-bank operators for their contribution to ‘Big Society’ rather than confess his shame for returning a civilised country to intolerable poverty.
In public health too we need to condemn victim-blaming and advocate for the health of the most vulnerable. Championing the health and rights of women and children in the early years is a key component of that.
The problem with the poor is poverty. The problems of violence and the problems of ill health are rooted in inequalities in opportunity and money between social groups, between geographical areas and between the sexes.
The North West Public Health Observatory in its tour-de-force report Protecting People, Promoting Health shows just what a massive public health problem violence is and gives us a public health approach to evidence to reducing it. It’s a Marmot report for violence-prevention and demonstrates how crucial early-years interventions and youth support are to reducing crime and violence.
But as well as its careful analysis of interventions which set the conditions for better health and positive, peaceful relations in communities, it also sets out a chapter on making behaviours which condone or encourage violence unacceptable. It is not women who are committing gang rape, it is not women who are off-loading barrel bombs from helicopters in Syria, and it is not women are gunning children down in US schools. But it is also not women who are determining the policies which are bringing about the impoverishment and bankruptcy of our nation and the next generation.
We in the public health community have been preoccupied with our own position in the NHS break up. I make no apology for that in the work of FPH – if we weren’t doing that no-one else was going to. But, as we look forward, it is time to look outwards, to re-establish our role as advocates for the health of the public. The health of the UK has not faced such a formidable threat for many years. The systematic impoverishment of the poorest, most disabled and most vulnerable is accelerating and will be given further thrusts in April and in October as the benefits cuts hit harder. Combining this with a fragmented and weakened health system, who will be there to hear the calls?
Educate a woman and you educate a village is as true for a UK housing estate family centre as it is for an African village.
And it’s as true for our national corporations, governments and institutions. As a new man fills another junior minister role, it appears there will be little new education in the Cabinet village.
In the new-year press, Professor Athene Donald continued her eloquent championing of the need for more girls to go into sciences. Looking for a happy new year for my daughters and granddaughters, and all our daughters and granddaughters, it is clear we need some fundamental power shifts. The public health specialty is well placed to demonstrate the greater involvement of women in all disciplines, and at the highest levels.
But in our advocacy for the public’s health, we must strive for greater equality for women, for the health of our national and the global village.
John Middleton, Vice President (Policy)