Dear party leaders,
Not only is health the foremost concern of individuals, communities, and businesses, health is also an indicator of how well a nation is performing. Unfortunately, the situation in the UK is deeply concerning. As you no doubt are aware health is declining and health inequalities are widening. This is not the case in other European countries, and the UK is now well below the EU average for how long people can expect to live in good health. The UK’s rankings have gone down since 2014.
While healthcare is important in treating ill health, the causes of ill health lie in the conditions in which people are born, grow, live, work, and age—tragically these conditions have deteriorated and resulted in worse health and shorter lives.
My recent analysis shows that 1 213 949 people’s lives were cut short between 2011 and 2020 in 90% of areas in England, as a result of avoidable social and economic inequalities.1
Austerity and regressive funding cuts harmed health and worsened health inequalities well before the covid-19 pandemic.2 Overall, the decade was marked by stalling life expectancy (declining for women living in the 10 percent most deprived areas).3 What a tragic waste. Especially so given the Conservative/Liberal Democrat Coalition government was presented with a blueprint of what to do in 2010 in my review Fair Society, Healthy Lives. The recommendations were endorsed by the then Government.4
Now, of course we also know exactly what not to do if we want to reduce health inequalities as a result of national policies since 2010.
While there has been a lack of effective policies nationally, there has been local action, including from the NHS, businesses, and the community, and voluntary sector. At the UCL Institute of Health Equity (IHE) we have worked with over 45 local authorities, healthcare organisations, businesses and the voluntary sector.567 We know what to do to tackle health inequalities and it is proving effective, even in the face of rising poverty and financial cuts.
The next government must have health equity at its heart to avoid more devastating and avoidable loss of lives. As we have seen in our work locally, all sectors must work together towards a common cause: equity of health and wellbeing.
The central plank of the next government must be to prioritise everyone’s health by implementing policies we know will reduce health inequalities. As most of our health is determined by our social circumstances, health equity and wellbeing must be put at the heart of all policies:
● Develop a national health inequalities strategy for action based on the following eight objectives:
1. Give every child the best start in life.
2. Enable all children, young people, and adults to maximise their capabilities and have control over their lives.
3. Create fair employment and good work for all.
4. Ensure a healthy standard of living for all.
5. Create and develop healthy and sustainable places and communities.
6. Strengthen the role and impact of ill health prevention.
7. Tackle racism, discrimination, and their outcomes.
8. Pursue environmental sustainability and health equity together.
● Appoint an independent Health Equity Commissioner.
● Establish a new cabinet level health equity and wellbeing cross departmental committee.
● Ensure every place and local government in the UK is set up and funded to prioritise equity of health and wellbeing.
Kind regards
Professor Sir Michael Marmot
