Published on January 31st, 2014 |
by Vittorio Trevitt
The shame of health inequalities and the need for a national strategy
The existence of health inequalities has long been one of the most tragic issues facing the United Kingdom. Despite the immense wealth that Britain enjoys, and while the average standard of living is regarded as one of the world’s highest, many people continue to face greater health problems and a shorter life than others due to factors such as poor health, inadequate diets, little or no income, smoking intake, and lack of exercise.
It should be a cause of national shame that such a situation exists, and a call to action to the government to formulate a national strategy to tackle this long-standing problem. During its 13 years in office, the Labour Party implemented various measures designed to tackle health inequalities. Health Action Zones (or HAZ’s) were set up in a number of areas to target poor health through initiatives such as sports and fitness programmes and investments in prevention and community development. The work of the HAZ’s raised awareness of the problem of health inequalities at the local level, together with developing partnerships structures and collaborative working and improving some mainstream services, especially in disadvantaged areas.
Smoking cessation programmes were set up in disadvantaged areas to reduce the chances of lung cancer, while the innovative Sure Start programme (together with incorporating targets for reducing smoking) aimed to integrate nutrition, health, and parenting into a care and education programme it operated. Baskets of fresh fruit were dispatched to schools, while doctors in poor parts of the country were able to prescribe gyms for their patients. Altogether, the various health policies carried out by Labour increased the life expectancy of the very poorest in society by 10 years.
Despite such policy innovations, there continues to exist wide disparities in health outcomes and life expectancy within and between local communities. In England, there is a seven-year gap in life expectancy between those living in the richest and poorest parts of the country, a gap that rises to 17 in some parts of London, while in Glasgow in Scotland, there is a 28-year life expectancy gap between rich and poor in the city. A report by Sir Michael Marmot from 2010 estimated that people dying prematurely each year as a result of health inequalities would have enjoyed, in total, between 1.3 and 2.5 million additional years of life if such a sad situation did not exist.
My home city of Brighton and Hove is no less affected by inequalities in health, with figures showing that men on average in Whitehawk and Moulscoombe can expect to die up to 10.6 years earlier and women 6.6 years earlier than the regional average, while the difference in disability-free life expectancy for men and women is greater, at 11.9 years and 9.1 years, respectively. In addition, almost half of the city’s population is estimated to have current or possible future health concerns linked to lifestyle issues. Such horrifying statistics are reflections of the inequalities that persist in Brighton and Hove, with deprivation higher than the England average and average earnings lower than the South East average.
Reducing health inequalities is also as much of an economic imperative as it is a moral one, as it is estimated that health inequalities not only cost the NHS £5.5bn each year, but they are also responsible for annual productivity losses of £31-33 billion, and cost taxpayers in England between £20 billion and £32 billion each year due to higher benefit payments and lost taxes.
A comprehensive strategy designed to tackle the causes of ill-health needs to be implemented if we are to witness a significant reduction in the inequalities in health that plague our society, together with reducing the economic costs borne by such an avoidable social tragedy. Increases in child benefits and maternity grants, improved conditions at work and community services, and improvements in child care provision would be steps in the right direction. The extension of the voluntary living wage of £7.45 to more businesses would also have a positive impact on health by making it easier for people on low incomes to afford healthier lifestyle choices.
To promote physical fitness, a system of subsides should be introduced to make membership of gyms and other sports providers more affordable. To improve the life chances of children, greater investments should be made in pre-school years, via initiatives such as high quality early years care and more parenting support programmes.
Research has found that by the age of 10, children from poorer backgrounds will have lost any advantage of intelligence indicated at 22 months, while children from affluent backgrounds, by contrast, will have improved their cognitive scores due to their advantages in income. A comprehensive strategy aimed at tackling health inequalities is therefore beneficial on the grounds of promoting equity and development from an early age, thereby increasing the numbers of children growing up to enjoy an active, healthy life.
It is both wrong and morally outrageous that in 21st Century Britain factors such as money, occupational status and shelter continue to determine the health of an individual. The government has a historic opportunity to rectify this situation. If it fails, then many lives will continue to be lost each year as a result of the failure to tackle health inequalities. If it succeeds, we will not only see an overall improvement in the health and well-being of our society as a whole, but we will be able to secure for future generations a society where a healthy life is a guaranteed right for all.
Please note that all blog posts do not represent the views of Catch21 but only of the individual writers. We also aim to be factually accurate and balanced across all content taken as a whole.