Levelling up needed to counter health inequality

IMPROVEMENTS to life expectancy in England have stalled and, for the poorest 10 per cent of women, have declined over the last decade, according to a report commissioned by the Health Foundation.

The report Health Equity in England: The Marmot Review 10 Years On looks at trends in health equality since the landmark study Fair Society, Healthy Lives

Among key findings is an increased correlation between deprivation and shorter life expectancy, and a steepening social gradient over the last decade. Marked regional differences can be found in life expectancy, with people living in deprived areas of the North East having a reduced life expectancy of nearly five years compared to similar areas in London.

The report also found that mortality rates are increasing for men and women aged 45 to 49 – perhaps related to so-called 'deaths of despair' (suicide, drugs and alcohol abuse) as seen in the USA.

Child poverty has increased to 22 per cent compared to Europe’s lowest level of 10 per cent found in Norway, Iceland and The Netherlands. This has been accompanied by closure of many children and youth centres, with less funding for education.

The authors of the report believe the slowdown in life expectancy increase cannot be attributed to severe winters. More than 80 percent of the slowdown between 2011 and 2019 results from influences other than winter-associated mortality. Other possible explanations include reduced public spending.

The report states: "Since 2010 there have been widespread and deep cuts in most areas of public spending, a result of austerity and government responses to perceived financial pressures. Government spending as a percentage of GDP declined by 7 percentage points between 2009/10 and 2018/19, from 42 percent to 35 percent. Cuts to local authorities have been hugely significant."

Chief Executive at the Health Foundation Dr Jennifer Dixon commented on the report: "To 'level up' the country as the government aims, it must take action to level up the health and wellbeing of the population, particularly between the north and south of England.

"A healthy population is one of the nation’s most important assets. The landmark Marmot review in 2010 showed striking differences in health between people living in the wealthiest and most deprived communities.

"The evidence is clear and the solutions are there – what is needed is the will to act. Where there has been progress, it has been fragmented and underpowered. Steps should now be taken to implement a package of policies over the next five years that will lay the foundations for sustainable improvement over the long-term. Areas that need immediate investment include addressing child and in-work poverty, the public health grant to local authorities, and children’s services such as Sure Start.

"To give coherence to this agenda, and to link with other initiatives like the industrial strategy, a new national cross-government health inequalities strategy is urgently needed – ideally with leadership by No.10."