Discours de remerciement – Rome, 18.11.2004 (anglais)

Royaume-Uni

Michael Marmot

Prix Balzan 2004 pour l'épidémiologie

Sir Michael Marmot a apporté une contribution fondamentale à l’épidémiologie en établissant des liens jusqu’ici insoupçonnés entre d’une part la santé et l’espérance de vie, et d’autre part le statut social. Il est à l’origine de l’ère de l’épidémiologie sociale et a préparé le terrain pour le développement d’un concept nouveau de médecine préventive.

Mr. President,

Members of the Balzan Foundation,

Ladies and Gentlemen,

It is alleged that the physicist, Richard Feynman, wrote to a student’s sceptical mother along the lines of: Your son has asked me to tell you why physics is important. Physics is not important. Love is important. Physics is fun.

He exaggerated to make a point. Research and scholarship are fun. They are also important. There is a third aspect. The particular field in which I have toiled, the social determinants of health, has the ethical purpose of reducing inequalities in society. For all these reasons, it is a particular pleasure to be recipient of the Balzan prize.

What about straight pleasure? Of course, pleasure for me, my family, co-workers and colleagues. A great deal of pleasure. I work at University College London where the remains of Jeremy Bentham stand guard outside the Provost’s office, and utilitarianism is a force to be reckoned with. These prizes certainly add to the total of human happiness. But were only pleasure at issue, our gathering today would lack meaning. The Balzan prizes celebrate scholarship and learning as important contributors to our civilisation and culture.

Such celebration of scholarship is greatly welcome. It is quite possible in the present climate to feel a little hunted as an academic, when the rhetoric is about practical applications, partnership with industry, efficient processing of large numbers of students in order to give them applicable skills. Commonly, Mammon is a more important god than knowledge. These Balzan prizes give us the opportunity to reflect on the value of scholarship.

I feel an enormous privilege to be an academic. It is indeed fun, but it is also a noble calling. I remember well my feelings as I set down the first words of my first scientific paper. It was close to a religious experience. I was entering a world where truth and knowledge were the currencies. It was a sacred duty and a privilege to participate in this world. Ask an academic the worst sin that another academic could commit in his line of work. It is lying. Disagreement, debate, relativistic viewpoints are acceptable but, at its best, our world is one in which there is pursuit of higher knowledge and understanding. This gathering celebrates this higher purpose.

With the Balzan prizes, we also celebrate today the value of different disciplines. I am trained in medicine and epidemiology, which means that we investigate the causes of disease in populations. I have spent the bulk of my research career investigating the social and cultural determinants of health. This entails collaboration with other branches of medical and biological knowledge, but it also involves psychologists, sociologists, economists, statisticians, and anthropologists. All have important contributions to make in furthering understanding of how the nature of society affects the health of members of that society. I am therefore particularly pleased to be here with representatives of such diverse disciplines, each of whom has their own unique contributions to knowledge.

There is a further, related reason that the Balzan brings particular pleasure. It endorses the way I go about my research life: research to accumulate knowledge linked with concern for social justice. My research has been devoted to understanding the reasons for social inequalities in health, why the less privileged in society should have the injury of poor health added to the insult of low status. Thus, my work aims to lay the basis for action to reduce inequalities in health. I am concerned that there are inequalities in health within countries – the 20 year gap in life expectancy between the poorest and the richest in America, for example; and inequalities between countries – why does a baby in Sierra Leone have a 30% chance of dying before the age of five, whereas a baby in Sweden has fewer than 4 chances in 1000 of dying at such an age. My colleagues and I do curiosity-driven research. But we have chosen the topic of social inequalities in health because of the claims of social justice. We want to make a difference. Reducing inequalities in health, too, is an inherently civilising pursuit. It is good for all of us who work in this area that this research endeavour should be honoured.

I am grateful to Balzan for celebrating the values of scholarship, grateful for recognising that different disciplines have their own way to the truth, and grateful for the opportunity the prize gives to enjoy supporting the research leaders of the future.