England’s health inequalities ‘unfair and unjust’

10 February 2010

Tower block

Most people in England don’t live as long as the rich and suffer more ill health, according to a major UCL-led review published today.

The review – Fair Society, Healthy Lives – proposes new ways to improve everyone’s health and reduce inequalities that it describes as ‘unfair and unjust’.

The Government asked Professor Sir Michael Marmot (UCL Epidemiology & Public Health) to conduct the independent review.

It concluded that, although health inequalities are normally associated with the poor, premature illness and death affects everyone below the wealthiest tier of English society.

People living in the most deprived neighbourhoods will on average die seven years earlier than people living in the richest neighbourhoods. Even more disturbing, people living in poorer areas not only die sooner, but spend more of their lives with disability – an average total difference of 17 years. The review has estimated the cost of health inequalities in England:

  • Productivity losses of £31 – 33 billion every year
  • Lost taxes and higher welfare payments in the range of £20 – 32 billion per year
  • Additional NHS healthcare costs well in excess of £5.5 billion per year

The review also 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.

The review calls for health inequalities to sit alongside tackling climate change as one of society’s core priorities. Creating a sustainable future is, the review argues, compatible with action to reduce health inequalities: sustainable local communities, active transport, sustainable food production, and zero carbon houses will all have health benefits across society.

The six main recommendations of the review are:

  • Giving every child the best start in life
  • 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

Professor Marmot, whose commission 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, 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."

Health Secretary Andy Burnham said the review would help the Government put in place a strategy to tackle health inequalities over the next decade.

“It is not right that where we live can dictate the state of our health. Everyone should have an equal chance at good health. I am passionate about getting to the heart of this issue and ensuring that young people can look forward to the same life expectancy regardless of where they are born. This report will help us make that historic achievement," Mr Burnham said.

For a comprehensive range of documents about Fair Society, Healthy Lives – including its terms of reference and more detail on its recommendations – follow the link above.

Image: A tower block


UCL context

UCL Epidemiology & Public Health is a multi-disciplinary department that aims to develop a better understanding of health and prevention of ill health through vigorous research and the development of research methodology. This knowledge is applied via undergraduate and graduate teaching, contributions to national and international health policy and contributions to the wider public understanding on health.

UCL’s research strategy defines Grand Challenges as those areas in which it is facilitating cross-disciplinary interaction – within and beyond UCL – and applying the institution’s collective strengths, insights and creativity to overcome problems of global significance. The first of these is the Grand Challenge of Global Health.

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