Most people in England aren’t living as long as the best off and spend longer in ill-health, according to a new report.
The review Fair Society, Healthy Lives proposes a new way to reduce health inequalities in England post 2010 and argues that traditionally government policies to reduce health inequalities have focused resources only on some segments of society.
To improve health for everyone, the review says, action is needed to build on the past ten years’ work on health inequalities 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 review has estimated that health inequalities in England are costing £31–33 billion in productivity losses, around £20–32 billion in lost taxes and higher welfare payments and an excess of £5.5 billion in additional NHS healthcare costs each 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.
NICE has welcomed the recommendations and has urged a focus on public health measures that prevent ill health. Professor Mike Kelly, Director, Public Health Excellence Centre at NICE, said: “Our guidance aims to improve the health of the population as a whole and to reduce health inequalities. The interventions we recommend are highly cost effective and represent very good value for money and hence are a good use of public funds.
A modest switch in resources to public health, to invest in those interventions which have been shown to be effective and cost effective by NICE, would from a societal point of view and a social justice point of view, be an important investment for the future.”
A team of 10 Commissioners drew up the recommendations, chaired by Sir Michael Marmot, Professor of Epidemiology and Public Health, University College London. 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 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 hopes to create conditions for people to take control over their own lives by:
- Giving every child the best start in life (highest priority recommendation)
- Enabling all children, young people and adults to maximise their capabilities and have control over their lives
- Creating fair employment and good work for all
- Ensuring a healthy standard of living for all
- Creating and developing sustainable places and communities
- Strengthening the role and impact of ill-health prevention.
The King’s Fund has also expressed approval of the recommendations, adding that the onus is now on politicians to reduce inequalities in areas such as housing, working conditions and education, as well as healthcare.
Acting Chief Executive Dr Anna Dixon added: “The problems that contribute to health inequalities are complex and longstanding. It is clearly the role of the NHS to help everyone improve their chances of living longer and healthier lives. But the health service cannot eradicate these inequalities on its own. It’s imperative that politicians continue to support the reduction of inequalities as a goal, even if the outcomes might not be achieved until after they have left office.”