I imagine many of us will be thinking back to this time last year – what we were doing, what were our preoccupations – before our world tilted on its axis. Maybe you were planning a conference? Worrying about a deadline you had to meet? Excited at the prospect of a new job? 

At the Health Foundation, we were busy finalising the plans for the publication of Health Equity in England: The Marmot Review 10 Years On. Some 18 months in the making, the review had been timed to coincide with the anniversary of the landmark Fair Society, Healthy Lives report. Published in February, little did we realise how apposite the timing would become. 

It was always our intention to put the stark differences in people’s health across the UK under the spotlight. But the events that unfolded meant that these inequalities were laid bare. Rather than being the great leveller, it quickly became clear that it is the differences in people’s health, their circumstances and their wider working and living conditions that most affect their exposure to, and outcomes from, COVID-19.  

Looking ahead, it is human nature to be optimistic. The vaccination is offering firm hope that lives put on pause for the last year will resume; that key workers who, through choice or necessity, have stood on the front line will finally be able to face some respite; and that friends and families will be reunited. 

But it would be wrong to forget the inequalities that have meant so many have been hit so hard. Or to ignore the long shadows that the pandemic will cast across so many lives. Shadows of unemployment, lost education, poor mental health and unmet health care needs. This makes the work of the Health Foundation’s Healthy Lives team more important than ever. So, it is satisfying to outline our plans for 2021. Plans with recovery at their heart.  

Local government was front and centre in the role of protecting communities from the virus. Supporting those that faced hardship, coordinating local efforts and using their knowledge of their place to tailor the appropriate responses. This year will see the start of two funding programmes directed at local government. Our joint programme with the Local Government Association, Shaping Places for Healthier Lives will support five local partnerships to develop whole system responses to pressing issues that jeopardise people’s opportunity to lead a healthy life. The Economies for Healthier Lives programme homes in on the specific role that economic development can play in creating the conditions for people to thrive.  

Working with the King’s Fund we will continue the project to understand, in real time, the role of Directors of Public Health during the pandemic in leading a system response. It will highlight the wider role of public health – not just health protection but also health improvement. We will also be waiting to hear the plans for the future of Public Health England’s public health improvement function. Building on the position set out in our briefing paper, we will be advocating for a strong public health infrastructure – coupled with an independent body to report to parliament on trends in the nation’s health. 

This spring we will launch our What drives health inequalities? evidence hub to hold in-depth analysis on the trends in the factors that have greatest bearing on our health. The long reads we’ve already published on the relationship between health and work, income and housing give a flavour of the content that will be available.  

The pandemic has hit young people hard. Interrupting their education, closing the sectors that provide much of their employment and placing limits on their ability to build the relationships that provide connections and emotional support. With this backdrop, the work of the policy posts we have funded at the Association for Young People’s Health, the Institute for Employment studies, the Resolution Foundation, the Royal Society of Arts and Sustrans take on a particular urgency. They will be providing insights into how the recovery will need to provide young people with the foundations for a healthy future.  

In July we will publish the findings from our COVID-19 impact inquiry. This will provide an in-depth assessment of how people’s experience of the pandemic was influenced by their health and existing inequalities. It will also look at the likely impact of actions taken in response to the pandemic on people’s health and health inequalities – now and in the future. 

In order to encourage a change in government policies, we know we need to work together with other organisations across different sectors who recognise their role in improving health and want to be part of a movement for change. That’s why our Collaboration for Wellbeing and Health will be using its collective voice to advocate for policies that can create and level up health, as well as building a public conversation about what makes us healthy and what needs to change to create opportunities for more people to live healthy lives. 

Finally, in our own karmic cycle, and picking up our plans before the pandemic took hold, we will be producing – in consultation with others – proposals for a cross-government strategy to close the health gap described nearly a year ago in Michael Marmot’s report. Proposals that will, if adopted, put health at the heart of the recovery.   

Jo Bibby (@JoBibbyTHF) is Director of Health at the Health Foundation.

This content originally featured in our email newsletter, which explores perspectives and expert opinion on a different health or health care topic each month.

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