A SHOCKING STORY OF HEALTH INEQUALITIES
“Place matters - living in a deprived area of the North East is worse for your health than living in a similarly deprived area in London, to the extent that life expectancy is nearly five years less.” (Marmot report; Ten years on)
A few weeks ago, on 25th February 2020, the Institute of Health Equity issued a startling report on a different kind of health crisis than the coronavirus pandemic. Unlike the pandemic, this other health crisis has been in the making for the best part of the last decade, throughout the years of austerity. It need not have happened. The report finds that improvements in life expectancy for the most deprived communities have not just ground to a halt but have actually gone into reverse. The situation of the millions living in poverty has grown much worse. It is not just the pandemic that cries out for urgent remedies but also the steadily building crisis of poverty and ill-health that afflicts millions of our fellow citizens.
The following is an extract from the report.
“20th century, England experienced continuous improvements in life expectancy but from 2011 these improvements slowed dramatically, almost grinding to a halt. For part of the decade 2010-2020 life expectancy actually fell in the most deprived communities outside London for women and in some regions for men. For men and women everywhere the time spent in poor health is increasing.
This is shocking. In the United Kingdom, as in other countries, we are used to life expectancy and health improving year on year. It is what we have come to expect. The UK has been seen as a world leader in identifying and addressing health inequalities but something dramatic is happening. This report is concerned with England, but in Scotland, Wales and Northern Ireland the damage to health and wellbeing is similarly nearly unprecedented.
Put simply, if health has stopped improving it is a sign that society has stopped improving. Evidence from around the world shows that health is a good measure of social and economic progress. When a society is flourishing health tends to flourish. When a society has large social and economic inequalities there are large inequalities in health. The health of the population is not just a matter of how well the health service is funded and functions, important as that is: health is closely linked to the conditions in which people are born, grow, live, work and age and inequities in power, money and resources- the social determinants of health.
The damage to the nation’s health need not have happened…. Health inequalities are not inevitable and can be significantly reduced… avoidable health inequalities are unfair and putting them right is a matter of social justice. … What we can envisage, and work towards, is a society that creates the conditions for everyone to be able to lead lives they have reason to value. That we do not have such a society at the moment is shown by the slowdown in life expectancy improvement, deteriorations in physical and mental health and widening health inequalities. “
The principal author of the report is Sit Michael Marmot. He is Professor of Epidemiology and Public Health at University College London. The report is an update of a report that he made ten years ago, The report provides detailed information on the health and life circumstances of deprived and disadvantaged people and makes a number of recommendations.
The Marmot report Ten years on;