Voluntary Action-Leeds has produced the following short briefing on Marmot Review 10 Years On

Marmot Review 10 Years On

To mark the 10-year anniversary of the landmark study of health inequalities, Fair Society, Healthy Lives, the UCL Institute of Health Equity (IHE) has launched Health Equity in England: The Marmot Review 10 Years On, commissioned by the Health Foundation.

The report examines progress over the past decade in addressing health inequalities in England and proposes recommendations for future action. The report also looks at the social determinants of health through policy areas outside the traditional ‘health and social care’ sector, including early years and education, work and income, housing, places and communities.

While there has been progress in some areas since 2010’s Fair Society, Healthy Lives, there is growing evidence that health inequalities are widening and life expectancy is stalling. The review finds that the more deprived the area, the shorter the life expectancy. There are marked regional differences in life expectancy, particularly among people living in more deprived areas.

The original Marmot Report contained recommendations for action in six key areas for Government:

  • Give every child the best start in life
  • Enable all children young people and adults to maximise their capabilities and have control over their lives
  • Create employment and good work for all
  • Ensure healthy standard of living for all
  • Create and develop healthy and sustainable places and communities
  • Strengthen the role and impact of ill health prevention
The 2020 Review demands six actions from government:
  • Develop a national strategy for action on the social determinants of health with the aim of reducing inequalities.
  • Ensure proportionate universal allocation of resources and implementation of policies: “changes to funding allocations and cuts to benefits have disproportionately affected poorer areas and communities and have been greatest in the North. Reversing these losses requires funding and action to be greater in those areas which have lost most, but universal as all areas have suffered cuts and widening inequalities.”
  • Early intervention to prevent health inequalities, through acting on the recommendations from the original Marmot Review.
  • Develop the social determinants of health workforce, building on successful partnership working with ‘non-health’ groups including the police, fire and rescue service, housing and education workforces.
  • Engage the public: “The public and political debate on health needs to move towards the social determinants and away from the overwhelming focus on individual behaviours and health care; this will help shift political focus and lead to greater investment and action on social determinants”.
  • Develop whole systems monitoring and strengthen accountability for health inequalities: a call for the Government to be more accountable, by establishing clear targets to bring up health standards in areas where health inequalities are at their highest – particularly the deprived areas of the north of England – up to the levels in London and the South.

A decade of austerity has seen significant funding cuts to local government. Considering whether austerity is the reason for the worsening health picture, Professor Sir Michael Marmot said it was “highly likely” that austerity cuts are responsible for the “life expectancy flat-lining, people’s health deteriorating and the widening of health inequalities.” He writes in the foreword to the report:

“From rising child poverty and the closure of children’s centres, to declines in education funding, an increase in precarious work and zero hours contracts, to a housing affordability crisis and a rise in homelessness, to people with insufficient money to lead a healthy life and resorting to food banks in large numbers, to ignored communities with poor conditions and little reason for hope… austerity will cast a long shadow over the lives of the children born and growing up under its effects.”

You can read a summary of the report including comments from the Health Secretary and Shadow Health Secretary on the Politics Home website and you can access the full report from the Institute of Health Equity website.