Perspectives
concerted and comprehensive approach. But what does this mean in practice? The good news is that it seems possible to reduce social inequalities. Wilkinson mentions the experience of England during World War II when there was a conscious effort by the government, for rather cynical reasons, to reduce the visibility of social inequalities so as to build a cohesive, broad, and sustained resistance to the serious threat from Germany. Unfortunately, the impact of this effort on health inequalities is not known. The Netherlands has identified several interventions likely to reduce
health inequalities, but under a previous government. In New Zealand, some progress has been made to tackle ethnic inequalities in life expectancy, although progress has been slow and has required a “whole of government” approach; this has not been easy to sustain in the context of strong conservative views in many sectors of the society. The critical question for public health practitioners is how to build the social movement to support nascent political efforts to address the unacceptable levels of health inequalities in all societies. The challenge is huge, especially given the continuing and
overwhelming faith in the power of market forces to overcome all social ills. These issues deserve a full— and urgent—discussion, perhaps one initiated by public health practitioners and building on the helpful insights from such contributions as The Impact of Inequality. The recommendations of the newly created WHO Commission on the Social Determinants of Health will hopefully substantially advance the inequalities policy agenda, especially in low and middle income countries.
Robert Beaglehole
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In brief Book Scientists on the screen
Mad, Bad and Dangerous? The Scientist and The Cinema Christopher Frayling. Reaktion Books, 2005. Pp 256. £19·95. ISBN 1-861-89255-1.
Frozen Angels Directed by Frauke Sandig and Eric Black, 2005. www.sandig.com/frozen-angels
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Cinema owes its invention to science, but according to Christopher Frayling in Mad, Bad and Dangerous? Scientists and the Cinema, soon after the birth of cinema, in 1895, film took a Frankenstein’s monster-style turn on its maker. Cinema’s unrealistic portrayal of scientists—as either impossibly evil or saintly—leaves today’s scientists worrying about how their public image can be improved. Frayling looks back at how scientists’ on-screen image has reflected society’s changing phobias about science and technology. From an obsession with the mad scientist in Fritz Lang’s Metropolis to 21st-century computer-expert Hollywood heart-throbs like Tom Cruise in Minority Report, via coldwar anxiety about the atomic age in Stanley Kubrick’s Dr Strangelove, scientists have always been portrayed in an exaggerated way. Frayling contends that these stereotypes are then distilled and perpetuated and, in turn, influence how science and scientists are viewed by the rest of society.
The basis of Frayling’s fascinating book is his belief that such simplistic representations of scientists have contributed to the gap between real science and the public’s understanding of scientific issues. Frayling hopes his hours spent “watching bad movies will not have been in vain” and that his book will encourage debate about how the public’s perception of science and scientists can be improved.
Rosie Taylor
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Film Reproductive realities
egg, Kari is helping her fourth couple to conceive, adding “I don’t like to think of myself as playing God, I’m more of an angel”. We also meet Bill Handel, radio host and owner of the world’s largest surrogate mother agency. Handel suggests that given the promise of genetic engineering, it’s only a matter of time before a client requests an embryo destined for modification. A somewhat unnerving gatekeeper to the next generation of Californians. Sandig and Black succeed in making a quirky and fascinating documentary. We encounter geneticists who talk of creating a new species of man, a company that has managed to patent a breast cancer gene, and see the way American seed—the overwhelming majority “blond-blue”—is shipped around the globe. Whatever next? Frozen Angels’ biochemist Cappy Rothman has the answer: “why not have a coastguards’ sperm-bank?” Brave new world indeed.
At last count California contained half a million frozen embryos, a bizarre consequence of unbridled capitalism. Indeed, the USA’s Golden State leads the world in reproductive technology and in Frauke Sandig and Eric Black’s documentary, Frozen Angels, we encounter some of those involved in this poorly regulated industry. There is the surrogate mother, the infertile couple, the biotechnologist, the test-tube baby, and the delightful Talha Burki Kari. Egg donor and all round good
[email protected]
www.thelancet.com Vol 367 February 18, 2006