Government must take action to level up the health and wellbeing of the population Launch of the Marmot Review 10 Years On: Health Foundation response

25 February 2020

Commenting on the launch of Health Equity in England: The Marmot Review 10 Years On, Dr Jennifer Dixon, Chief Executive at the Health Foundation, said:

‘To ‘level up’ the country as the government aims, it must take action to level up the health and wellbeing of the population, particularly between the north and south of England.

‘A healthy population is one of the nation’s most important assets. The landmark Marmot review in 2010 showed striking differences in health between people living in the wealthiest and most deprived communities.

‘Today’s report, commissioned by the Health Foundation, shows that things are now worse, especially for women. There has been a decrease in the proportion of our lives that we can expect to live in good health. And not only has the health gap grown between wealthy and deprived areas, it has also grown between deprived areas. Living in a deprived area of the North East is worse for your health than living in a similarly deprived area in London, to the extent that life expectancy is nearly five years less. Place matters.

‘Having secured new support from ‘red wall’ areas that are at the sharp end of rising health inequalities, the government now has a real opportunity to show leadership on improving health. ‘Levelling up’ will require the government to go further than investment in infrastructure – building bridges, train lines and new hospitals. It must also invest in the circumstances in which people live that have powerful impacts on their health and wellbeing – such as poverty, employment, housing and education.

‘The evidence is clear and the solutions are there – what is needed is the will to act. Where there has been progress, it has been fragmented and underpowered. Steps should now be taken to implement a package of policies over the next five years that will lay the foundations for sustainable improvement over the long-term. Areas that need immediate investment include addressing child and in-work poverty, the public health grant to local authorities, and children’s services such as Sure Start.

‘To give coherence to this agenda, and to link with other initiatives like the industrial strategy, a new national cross-government health inequalities strategy is urgently needed – ideally with leadership by No.10. This should join the dots on existing efforts, coordinate, scale and boost action, set some manageable targets to reduce health gaps, and publicly measure performance against them. Important ingredients must include how local government can be better supported to make progress, what businesses could contribute, and whether a ‘grand challenge’ to reduce the regional health gap could usefully focus efforts.

‘As the Marmot 10 Years On Review notes: “If health has stopped improving it is a sign that society has stopped improving”. What is government for if not to act on that?’