These roots [of health inequalities] lie primarily in what Dr. Marmot identifies as the social determinants of health (SDH). These are not simply economic, although of course poverty is associated with bad health—a link established in the 19th century by Edwin Chadwick in Britain and Lemuel Shattuck in the U.S. But “poverty is not destiny,” Dr. Marmot insists. Rather, he seeks to develop a model of SDH that is intrinsically linked with human autonomy and control. Prosperity brings all sorts of empowerments, just as poverty denies them. It is the empowerment rather than the absolute poverty that he believes is most crucial.