People die 7 years earlier in england's poorest neighbourhoods

People die 7 years earlier in england's poorest neighbourhoods

According to a new government-commissioned report, people living in England's poorest neighbourhoods die on average seven years earlier than those living in the richest neighbourhoods and they also spend more of their shorter lives with disability leaving the better off with a total of 17 more years of disability-free life.

Released on 11 February, "Fair Society, Healthy Lives", also known as the "Marmot Review" after Sir Michael Marmot, Professor of Epidemiology and Public Health, University College London, who conducted the independent review on the request of the Secretary of State for Health, shows that most people in England aren't living as long as the best off and spend more their shorter lives in ill health.

The review estimates the annual cost of health inequality in England as:

  • Loss of productivity: £31 to £33 billion.
  • Lost taxes and welfare payments: £20 to £32 billion.
  • Additional NHS costs: well over £5.5 billion.
  • Predicted increase in the cost of treating just the obesity-related illnesses due to inequality will from £2 billion to nearly nearly £5 billion per year by 2025.
It notes that government tends to focus only on some segments of society when it aims resources at reducing health inequality, but to improve the health of all segments, the review argues that more should be done to reduce differences that are both unfair and unjust.

The report calls for reduction in health inequality to sit alongside climate change as a core national priority, emphasizing that creating a sustainable future is entirely compatible with reducing health inequality because creating sustainable communities, developing an active transport system, producing food sustainably and achieving zero carbon houses will result in health benefits across society.

The report includes recommendations from a team of Commissioners chaired by Sir Michael on how to reduce health inequalities in England. The 10 Commissioners include Professor Ian Gilmore, the President of the Royal College of Physicians, and Professor Ian Diamond, the Chief Executive of the Economic and Social Research Council.

In reaching their conclusions the reviewers consulted not only the scientific literature but also a wide range of stakeholders in central and local government, political parties, the health services, the private sector, charities, not-for-profit and voluntary sectors.

Their main recommendations are to create conditions that help people take control of their lives by:

  1. Giving every child the best start in life: starting in the womb, a person's lifelong health is heavily influenced by what happens in their early years, studies have shown this impacts obesity, heart disease, and mental health as well as educational achievement and economic status. While later interventions work, they have less impact, so the recommendation stresses the importance of rebalancing public spending to prioritize the early years, for instance through more parenting support (eg increasing parental leave), better quality early years care, and improved training for the early years work force.
  2. Empowering children, young people and adults to take control of their lives: educational achievement enables people to maximize their capabilities and talents and brings many benefits including better employment, income and mental health, said the review, stressing that research shows families have more influence here than schools and the focus should be to foster closer links among schools, families and communities. The report also recommends increasing availability of non-vocational life-long learning.
  3. Creating fair and good employment for everyone: research shows that being employed is better for people's health, while being unemployed contributes to poor health. By fair and good the committee means having a decent living wage, having the chance to develop skills and talents in the workplace, good management practices, making it possible for people to balance the demands of work and family, and protection from adverse working conditions that can damage health. A key recommendation in this area is to implement guidance on stress management and the effective promotion of wellbeing and physical and mental health at work.
  4. Developing and implementing a Minimum Income for Healthy Living (MIHL) standard: to help ensure a healthy standard of living for everyone. A significant cause of health inequality is not having enough money to lead a healthy life. MIHL would be a level of income sufficient to ensure adequate nutrition, physical activity, hygiene, medical care, transport, housing, and participation in activity at the individual and community level.
  5. Creating and developing sustainable communities: many of the policies to address climate change would also be effective in reducing health inequalities argue the Commissioners, such as making it possible for people to do more walking, cycling and go into green spaces. Living in good quality neighbourhoods, including both physical and social environment, and social support within and between communities, has a positive impact on people's physical and mental health.
  6. Strengthening role and impact of health prevention: there is a clear upward relationships between income, wealth and disease, with the poorest in society suffering the worst health, and the richest enjoying the best health. Many unhealthy behaviours and traits like smoking, obesity, levels of physical activity and drug misuse that contribute to diseases like heart disease and cancer follow this social "health gradient", said the Commissioners, and in order to flatten it, more of the current national health budget should go toward prevention (it is currently only 4 per cent of NHS spending) and treating drug misuse as a medical problem.
Sir Michael told the press that:

"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," he added.

-- Fair Society, Healthy Lives

Source: University College London.

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