Air pollution is the largest environmental risk to public health and children are especially vulnerable

I studied medicine at the University of Cape Town, graduating in 1989. Over six years as an undergraduate I was taught the science of medicine by teachers who were superb scientists and clinicians. I graduated with a keen sense of pathology, anatomy, microbiology and all the specialties. Unsurprisingly, I was acutely aware of how the politics of the day impacted on how I practised medicine in South Africa and from a very early undergraduate stage it didn’t take a genius to realise that ethnicity had a direct impact on the pattern of diseases and patient outcomes. Yet we were not taught about the social determinants of health—I don’t think the concept even existed then.Don Berwick, Emeritus President of the Institute of Healthcare Improvement in the US, recently wrote: “It is not a smart investment for society to keep running healthcare as a repair shop without also moving upstream to the…
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