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Society Affected By Health Inequalities PDF Print Email
This is according to a report just published - Fair Society, Healthy Lives - which proposes a new way to reduce health inequalities in England post 2010.

Inequalities in health are usually associated with the poorest in society, but the report highlights the premature illness and death that affects everyone below the top. The Review argues that traditionally government policies to reduce health inequalities have concentrated resources only on some segments of society. The Review says that to improve health for all of us action is needed to build on the past ten years work to continue to improve everyone’s health and reduce differences that are both unfair and unjust.

At the moment people living in the poorest neighbourhoods in England will on average die seven years earlier than people living in the richest neighbourhoods. And even more disturbing, people living in poorer areas not only die sooner, but spend more of their shorter lives with disability – an average total difference of 17 years.

The estimated cost of health inequalities in England:
•Productivity losses of £31-33 billion every year
•Lost taxes and higher welfare payments in the range of £20-32 billion per year
•Additional NHS healthcare costs well in excess of £5.5 billion per year

The Review predicts an increase in the cost of treating the various illnesses that result from inequalities in obesity alone to rise from £2 billion per year to nearly £5 billion per year by 2025.

Sir Michael Marmot, Professor of Epidemiology and Public Health, University College London, was asked by the Secretary of State for Health to conduct the independent review. A team of 10 Commissioners drew up the recommendations. They included the President of the Royal College of Physicians, Professor Ian Gilmore, and the Chief Executive of the Economic and Social Research Council, Professor Ian Diamond. Sir Michael, who chaired the Commission, said:

“There will be those who say that our recommendations cannot be afforded, particularly in the current economic climate. We say that it is inaction that cannot be afforded, the economic and more importantly human costs are simply too high.

The health and wellbeing of today’s children, and of those children when they become adults, depend on us having the courage and imagination to do things differently, to put sustainability and well-being before a narrow focus on economic growth and bring about a more equal and fair society.”

The Review is calling for health inequalities to sit alongside tackling climate change as the core of society’s achievement. Creating a sustainable future is, the Review says, entirely compatible with action to reduce health inequalities: sustainable local communities, active transport, sustainable food production, and zero carbon houses will all have health benefits across society.

Main Recommendations - the central ambition of the Review is to create conditions for people to take control over their own lives by:

1. Giving every child the best start in life (highest priority recommendation) – what happens during early years (starting in the womb) has lifelong effects on many aspects of health and well-being from obesity, heart disease and mental health, to educational achievement and economic status. Later interventions, although important, are considerably less effective where good early foundations are lacking. That is why the Review proposes a rebalancing of public spending towards the early years, more parenting support programmes, a well trained early years work force and high quality early years care.
2. Enabling all children, young people and adults to maximize their capabilities and have control over their lives – educational achievement brings with it a whole range of achievements including better employment, income and physical and mental health. Evidence suggests it is families rather than schools that have the most influence on educational attainment therefore building closer links between schools, the family, and the local community are important to reducing educational inequalities.
3. Creating fair employment and good work for all – being in employment is protective of health; conversely unemployment contributes to poor health. Jobs need to offer a decent living wage, opportunities for in-work development, good management practices, the flexibility to enable people to balance work and family life, and protection from adverse working conditions that can damage health.
4. Ensuring a healthy standard of living for all – having insufficient money to lead a healthy life is a highly significant cause of health inequalities. Standards for a minimum income for healthy living (MIHL) need to be developed and implemented – the calculation includes the level of income needed for adequate nutrition, physical activity, housing, individual and community interactions, transport, medical care and hygiene.
5. Creating and developing sustainable places and communities – many policies which would help mitigate climate change would also help reduce health inequalities – for instance more walking, cycling and green spaces. The Review proposes common policies to reduce the scale and impact of climate change and health inequalities. Good quality neighbourhoods can make a significant difference to quality of life and health – this relates both to the physical environment and to the social environment. Social support, within and between communities is critical to physical and mental well-being.
6. Strengthening the role and impact of ill-health prevention -
there is a clear relationship between income, wealth and disease. The poorest in society suffer the most, those slightly above them in society suffering less, those slightly above them less still and so on. We call this the health gradient. And like any gradient, its steepness is hugely significant and gives rise to the health inequalities we have in England. Many of the health behaviours related to the development of diseases, such as heart disease and many cancers, follow a social gradient. These diseases relate to smoking, obesity, levels of physical activity and drug misuse, themselves related to income, levels of education, quality of environment and so on. In order to flatten the gradient, the Review argues for more funding to prevent ill-health (currently this is only four percent of the NHS budget) and action to treat drug misuse as a medical problem.