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Health Inequalities: Strategies for Action

Health Inequalities: Strategies for Action . Dr Jessica Allen 21/9/11 www.marmotreview.org. English Review Further English work European Review Global network. Fairness at the heart of all policies.

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Health Inequalities: Strategies for Action

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  1. Health Inequalities: Strategies for Action Dr Jessica Allen 21/9/11 www.marmotreview.org

  2. English Review • Further English work • European Review • Global network

  3. Fairness at the heart of all policies. • Health inequalities result from social inequalities – requires action on all the social determinants; the causes of the causes • Focusing solely on the most disadvantaged will not reduce inequalities sufficiently – action is needed across the social distribution.

  4. Fair Society: Healthy Lives: 6 Policy Objectives • Give every child the best start in life • Enable all children, young people and adults to maximise their capabilities and have control over their lives • Create fair employment and good work for all • Ensure healthy standard of living for all • Create and develop healthy and sustainable places and communities • Strengthen the role and impact of ill health prevention

  5. Action in England Local authorities PCTs National Government – public health white paper Other government departments Indicator - data

  6. BUT • Health system changes • Lip service – lifestyle drift • Targets and indicators • Wider workforce • Health service predominates • money…

  7. Marmot Review inter and intra LA data: • Life expectancy • Health expectancy • (Wellbeing) • Readiness for school • Young people not in education, employment or training • Income (after tax and benefits) sufficient for healthy living

  8. Range of male life expectancy within local authorities: England

  9. English publications • Fuel poverty – Health Impacts of cold homes • Barts and London workforce strategy • NHS Workforce – what NHS workforce can do to tackle SDH

  10. Future work • What does a H & WB that takes SDH approach to Health inequalities seriously look like? • London Health Improvement Group • What does a CCG that takes SDH approach to health inequalities seriously look like? • What does a NHS workforce that takes health inequalities seriously look like • Acute sector?

  11. EUROPEAN REVIEW OF SDH AND THE HEALTH DIVIDE • 53 countries of Europe • Description and analysis of evidence • Propose interventions at variety of levels • Propose delivery system • Intra governmental and NGOs, private sector, health system, local government, other stakeholders.

  12. Life expectancy at birth by sex for countries in the WHO European Region, 2008 or latest available year: males 55 60 65 70 75 80 85 life expectancy at birth - males European Review of Health Inequalities and the Health Divide

  13. Life expectancy at birth by sex for countries in the WHO European Region, 2008 or latest available year: females 55 60 65 70 75 80 85 life expectancy at birth - females European Review of Health Inequalities and the Health Divide

  14. Life expectancy at age 15, men, 1970-2007 European Review of Health Inequalities and the Health Divide From WHO Health For All database

  15. Self reported good health by income quintiles: Latvia and Sweden Percentage in good/ very good health EU SILC 2008 data, Bradshaw & Mayhew personal communication 2010 European Review of Health Inequalities and the Health Divide

  16. Emerging themes • adoption of human rights and asset-based approaches and societal approaches to well being. • organisations and governance are critical to successful action on the social determinants; • the need to intervene across the whole of the population – not just with the most deprived groups – with an intensity of action that is proportionate to need; • ensuring that actions taken are relevant across the diversity of countries in the WHO European Region; • recognising that empowerment of civil society is a vital ingredient of successful action; • the importance of global processes and influences and linking with the agenda for climate change; and, • the need to provide evidence on the social and economic costs of inequities.  

  17. Consultation on European Review • To stimulate debate • To build further political support, policy alliances and capacity for a social determinants approach • Input is sought on the strategic conceptual approach developed so far by the Review • Additional, evidence and examples are sought of promising practice in tackling health inequities through action on the social determinants of health

  18. Global Network • Rio • PAHO, EURO • Norway, Slovenia, England, Denmark, Sweden, Malmo • Chile - Ministry of Health review • Argentina - appointed a vice-Minister of Health with responsibility for health equity • Brazil - Commission on Social Determinants of Health • Costa Rica - implemented whole of government approach • Australia - an initiative from WHO and South Australia, the Adelaide Statement on Health in All Policies • The Asia-Pacific Network of HealthGAEN (Global Action for Health Equity Network) - a regional collective progressing the health equity agenda (14). • WHO Virtual global network

  19. UCL Institute of Health Equity Website www.marmotreview.org

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