UK Government

Department of Health: Fairer health in the future

Press Release   •   Feb 11, 2010 10:38 GMT

Health Secretary welcomes goals for the next decade

A major report on tackling health inequalities for the next 10 years and beyond was welcomed today by the Secretary of State for Health, Andy Burnham.

Professor Sir Michael Marmot of University College London was asked by the Government to provide a clear set of short, medium, and long term objectives to inform how health inequalities can be dramatically reduced.

The report “Fair Society, Healthy Lives” is a thorough and comprehensive analysis of health inequalities in England today and it identifies key areas for future action. It will help set the direction beyond current targets, for the next 10 years and beyond.

Health Secretary Andy Burnham said:

“I would like to thank Sir Michael Marmot and his team of eminent experts, for this review. It builds on previous highly influential reports commissioned by the Government from Sir Douglas Black and Sir Donald Acheson and will help us put in place a strategy to continue 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.

“Sir Michael has previously acknowledged our tremendous achievements – that the health of everyone has significantly improved over the last 10 years, and infant mortality is at an all-time low.

“The report shows us there is still much to do – so we are looking to all corners of the community to work together and address the wider causes of poor health and reduce health inequalities.  This report gives us a new and challenging agenda – based on the best available evidence - for the next 10 years and beyond.”

Key achievements in reducing health inequalities have meant that there are now more than two million fewer adults who smoke compared to twelve years ago; there are signs that childhood obesity rates are levelling off thanks to initiatives like the Healthy Child Programme; and the Government has provided additional funding for our most poorly served and disadvantaged areas with better access to primary care and GP-led health centres.

The Government welcomes the report and

  • supports the focus on tackling the root causes of ill health and inequality to build on what has already been achieved. This means following through on the current national health inequalities target on infant mortality and life expectancy which runs to the end of 2011
  • acknowledges the challenge posed by a social gradient - the lower a person’s social position, the worse his or her health. Tackling health inequalities requires a cross-government response and the involvement of all key stakeholders to reduce the gradient in health;
  • recognises the potential of initiatives that give extra attention to tackling disadvantage, especially in the early years.  The Government’s efforts in adopting this approach – through, for example, Family Nurse Partnerships – are acknowledged in the report;
  • emphasises that both economic growth and improved health and well being are crucial measures of the country’s success. Action cannot be ignored even in the current economic climate;
  • recognises that health inequalities sit alongside other social factors such as climate change and sustainable communities. Walking or cycling and the availability of green spaces will have benefits across all of society; and
  • stresses that any future strategy will need to take full account of the different aspects of health inequalities as well as social class.  These include gender, ethnicity, area, age and disability and strongly affect health and life chances.

Children's Minister Dawn Primarolo said:

"The Marmot Review recognises the key role played by children's centres in reducing health inequalities and I welcome the focus on the early years. It is Government's priority to support all new parents and give every child the best start in life. That's why we are establishing more children's centres with more effective outreach to the most disadvantaged families. We are on track to achieve our target of 3,500 children's centres by March 2010. By 2011 we will be investing over £1billion a year directly to support services in children's centres and we have committed to providing a named health visitor for each children's centre.

"Over the last decade we have made substantial progress in narrowing the gap between children from disadvantaged backgrounds and the rest - the average achievement for those pupils has risen more sharply than for others. And obesity levels amongst two to 10 year olds are at the lowest level since 2001.

"We are building on this with the successful Healthy Child Programme, providing more early intervention to all families from pregnancy to five years of age, with more guidance for parents so that they make healthy choices for their family. We are also making sure that the poorest families benefit from the free entitlement to early learning and childcare."

Notes to editors

1.      For further information please contact the DH press office on 020 7210 5221.

2.      The independent review was announced on the 6 November 2008 by the Prime Minister at the Closing the gap international health inequalities conference and commissioned by the Secretary of State for Health.  The purpose of the report was build on current work by informing the development of a post-2010 cross government health inequalities strategy.

3.      It was carried out by Professor Sir Michael Marmot, one of the world’s leading experts on health inequalities. The review builds on a range of evidence including from the World Health Organization’s Commission on the Social Determinants of Health Commission – also chaired by Sir Michael.  Other evidence consulted by the review included Tackling Health Inequalities: 10 Years On (DH, 2009) which set out the government’s record since the Acheson report on health inequalities and Health Inequalities (2009), the report of the Health Select Committee.

4.      England is one of the first countries to explore how the global evidence from the WHO report can help take forward the work on tackling health inequalities in the long term.

5.      Health inequalities was reaffirmed as a national target for England in the new Departmental Strategic Objective structure for the Department:
By 2010 to reduce inequalities in health by 10% by 2010 as measured by infant mortality and life expectancy at birth i.e.

·             starting with children under one year, by 2010 to reduce by at least 10 per cent the gap in mortality between the routine and manual group and the population as a whole. The baseline is 1997-1999;

·             starting with Local Authorities, by 2010 to reduce by at least 10% the gap in life expectancy between the fifth of areas with the “worst health and deprivation indicators” (the Spearhead Group) and the population as a whole. The baseline is 1995-1997.

6.      The latest data for 2006-08 showed that life expectancy in England and in the spearhead group is at record levels.

·        for men in England, life expectancy has increased from 74.6 years at baseline (1995-97) to 77.9 years in 2006-08, compared to men in the spearhead group where life expectancy has increased from 72.7 years to 75.8 years.

·        for women in England, life expectancy has increased from 79.7 years at baseline to 82.0 years in 2006-08, compared to women in the spearhead group from 78.3 years to 80.4  for men.

7.      The relative health inequalities gap between England and the spearhead group was for men 7% wider than at baseline, and for women 14% wider than at baseline.

8.      The latest data (2006-08) show that 47% of spearheads are on track to narrow their own life expectancy gap with England by more than 10% by 2010 compared to the baseline for either males, females or both.  The spearhead  areas which are showing encouraging signs where life expectancy is increasing faster than the England average include:

·        In Southwark, the gap in female life expectancy with the England average has not only narrowed, it has closed completely.  In 1995-97, female life expectancy in Southwark was 78.7 years; in 2006-08, it was 82.4 years - higher than the England average life expectancy for women of 82.0 years.

·        In Manchester, despite having low life expectancy, the life expectancy gap for men is closing.  In 1995-97, male life expectancy in Manchester was 70.1 years; in 2006-08, it was 73.8, an increase of 3.7 years (compared to the England average increase of 3.3 years).

9.    Infant mortality rates are at an all time low having fallen in England from 5.6 deaths per 1,000 live births in 1997-99 to 4.5 deaths per 1,000 lives births in 2006-08 for all jointly registered births. For the routine and manual (target) group the rates has fallen from 6.3 in 1997-99 to 5.2 in 2006-08.  The gap between the routine and manual group and the whole population is 16%, wider than at baseline (13%) but it has fallen back from 19% in 2002-04.

10.  The Government is committed to tackling inequality and has a long and successful history of doing so. Despite our progress, the report from the National Equality Panel, published last month, showed that your family background and the place you are born still have a huge influence on your outcomes in life.

The socio-economic duty in the Equality Bill will ensure public bodies such as health authorities look at ways of reducing the effects of inequality, and Marmot's detailed analysis of health inequality will help everyone in public life achieve this.

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