This backgrounder is part of a Local Democracy Research Centre paper on global health inequalities. Read Still unequal: dealing with health inequalities through the pandemic and beyond
Marmot principles for addressing health inequalities
‘Fair Society Healthy Lives’, the final report of the Marmot Review, was published in 2010. Sir Michael Marmot had been commissioned to analyse the causes and extent of health inequalities in England and identify what could be done to improve health.
People with a higher socioeconomic position in society have a greater array of life chances and more opportunities to lead a flourishing life. They also have better health. Marmot demonstrated how the two are linked: the more favoured people are, socially and economically, the better their health. This link between social conditions and health is not a footnote to the ‘real’ concerns with health – health care and unhealthy behaviours – it should become the main focus.
In England, people living in the poorest neighbourhoods, will, on average, die seven years earlier than people living in the richest neighbourhoods Even more disturbing, the average difference in disability free life expectancy is 17 years. So, people in poorer areas not only die sooner, but they will also spend more of their shorter lives with a disability. To illustrate the importance of the gradient: even excluding the poorest five per cent and the richest five per cent the gap in life expectancy between low and high income is six years, and in disability-free life expectancy 13 years. (Marmot, Fair Society Healthy Lives, 2010)
LGIU members The Health Foundation published Health Equity in England: The Marmot Review 10 years on in March 2020 just before the pandemic hit the UK (see LGIU briefing here).
The report had a stark conclusion that in five priority areas health is “worse (since the 2010 Marmot Review) for people lower down the socioeconomic hierarchy” in areas as wide as children’s life chances, realising everyone’s potential, ensuring everyone has a healthy standard of living, creating fair employment for all, and developing healthy and sustainable places.
The Health Foundation described life expectancy slowing and even reducing for some of the most deprived areas, while wide gaps in healthy life expectancy and significant regional health inequalities persist, particularly between London and the South East, and the North.