One of Wellesley’s themes is that the complex and inter-dependent nature of the social determinants of health require comprehensive policy and community responses. Illustrating this, I spoke recently at a conference on how climate change adaptation policy has to take account of health equity. The report of that conference has just come out. And it is startlingly timely: the health impact of the current heat wave is doubly worse for those facing poverty, inequality and exclusion. These populations lower down the social gradient of health have a greater burden of heart, respiratory and other chronic conditions – conditions which are made worse in heat. To make matters worse, accessing cooler environments, gardens, air conditioning and safe outdoor space to escape the heat, is more difficult.