Tag Archives: health inequalities

“Invest in people and their communities”

This is the call of the Health Foundation charity in its final report this month from a long-running enquiry into the impact of COVID-19. Calling on the Government to address the root causes of poor health, the report makes clear that the investment required into people and communities will involve jobs, housing, and education, plus action to ‘level up’ health.

In the report, they say;

The pandemic has revealed stark differences in the health of the working age population – those younger than 65 in the poorest 10% of areas in England were almost four times more likely to die from COVID-19 than those in the wealthiest. Recovery needs to prioritise creating opportunities for good health – a vital asset needed to ‘level up’ and rebuild the UK recovery.

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What’s our approach to ‘Levelling Up’?

Andy Haldane, about to leave the Bank  of England where he has long been its respected chief economist, told the audience at Policy Exchange, the Conservative think tank, on Monday June 28th that ‘Levelling Up’ should now be the central issue in our domestic politics.  That’s a radical statement, which should make Liberal Democrats think carefully about how we develop our response to this challenge.

Haldane pointed out that there are only two EU member states where inequality between the richest and poorest regions are as high as in the UK: Romania and Poland.  He noted how economic (and social) imbalances across the UK have widened over the past 30-40 years.   He did not add (though Liberals would underline) that gross inequalities undermine social order and democratic government.  His broad agenda includes investing in education and skills, encouraging local enterprise and innovation, and a far larger British Business Bank, in addition to improving transport infrastructure and housing.  And he emphasised that this agenda cannot simply be directed from the centre: it requires regional and local initiative, with substantial powers and finance devolved.

On Tuesday Sir Michael Marmot issued his latest report on regional and local inequalities, focussing primarily on England’s North-West. This further spelt out the gulf between the wealthiest and poorest in our society, including the wide differences in health and life expectancy between prosperous and deprived communities.  His agenda for change is similar to Haldane’s: investment in education, local public services, job creation and housing, in addition to the government’s current plans for improved infrastructure.  ‘We need to spend for future generations’, Marmot told the BBC.

Boris Johnson promised to level up Britain – and to ‘Build Back Better’ after the pandemic – without defining what that meant or how it would be paid for.  Others, outside partisan politics, are now spelling out what will be required if the promise is to be fulfilled.  Polls show that many who voted Leave five years ago saw Brexit as the opportunity to rebuild British industry (blaming the EU for globalization, foreign takeovers and technological change).  They also show that Johnson’s rhetoric on levelling up resounded with voters in ‘red wall’ seats.

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Build Back Fairer: the new mantra for now

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This title is about health equity issues, however, not building better houses. Professor Sir Michael Marmot, author of the Marmot Review – Health Equity in England Ten Years On which was published in February this year, has led a follow-up study called Build Back Fairer: The Covid-19 Marmot Review.

The new report highlights how inequalities in social-economic conditions before the pandemic contributed to the high and unequal death toll from Covid-19.

The enduring social and economic inequalities in society mean that the health of the public was threatened before and during the pandemic and will be after. Just as we needed better management of the nation’s health during the pandemic, so we need national attention to the causes of health inequalities.

Professor Marmot is as unflattering here about the present state of affairs as he was in his ten-year report. He writes, “Poor management of the pandemic was of a piece with England’s health improvement falling behind that with other rich countries in the decade since 2010”. That, he recalled, was for several reasons including that “the quality of governance and political culture did not give priority to the conditions for good health”, that there was increasing inequality in economic and social conditions, a rise in poverty among families with children, plus a policy of austerity and consequent cuts to funding of public services.

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