Health inequalities and the disparity between certain socio-economic groups have been a cause for concern for many years. Governments have struggled to implement policy that effectively confronts the issue. The health gap has manifested itself in different ways for different groups, some struggling to access care, with some receiving a poor quality of care.
In 2008, the World Health Organization (WHO) conducted a review, ‘Closing the Gap in a Generation’, as a global movement to promote health equity. Consequently, the Labour government then played its part by commissioning the ‘Marmot Review: Fairer Society, Healthy Lives’ for a robust, evidence-based review on measures for national and local governments to address health inequalities through targeted policy.
Health inequalities revealed in the Marmot Review
Twelve years later, in 2020, the Institute for Health Equity published a follow-up report, ‘The Marmot Review 10 years on’ which highlighted some stark findings:
- Life expectancy has stalled since 2010; in the most deprived areas, it has declined
- People are spending more of their lives in poorer health
- There has been no national strategy to address health inequalities since 2010.
A driving factor of these health declines has been the austerity measures imposed by a decade of Conservative and Liberal Democrat governments. Despite economic growth from 2010 to 2019, there was no adequate funding of public services, ultimately leading to a far greater unequal society.
A proposition: a health policy for the Labour Party
To improve the nation’s health, governments and parties ought to do more than just identify the causes of health disparities. The Labour Party should use the principles and policy recommendations of the Marmot Review to design an ambitious health policy for their manifesto, which they can focus on in future elections.
Many of the policy ideas proposed in this article have been inspired from findings of the Marmot Review and analyses of the work since its publication.
Namely, the report proposes two key policy objectives for tackling health inequalities. The first is to give every child the best start in life, and the second, to maximise their capabilities and have control over their lives.
Investment in schools can ensure health equality
To do this, politicians and policymakers should look to provide the tools and investment for schools and education services to deliver teaching at a ‘whole childcare’ approach. This would build a society towards aspiration. By extending the role of schools, children and adolescents would be better equipped with the skills and qualifications needed to control their own lives and preparedness for the life of work.
In this new model, it is especially important during these early stages of life to break down those social gradient barriers. This would allow schools to maximise the full potential of every child in our society.
The aim is for education systems to go beyond being solely institutions delivering academic prowess, but also to help build transferable knowledge and skills that would enable children to reach their full potential and develop healthy lifestyle skills to manage the personal and social challenges faced in adulthood.
Developing health habits and skills
To ensure national health equity, young people in education would benefit from dedicated teaching sessions on healthy habits/skills.
First and foremost, advice on healthy eating, where they are given simple and easy recipes, and tips on how to cook nutritious meals whilst managing a work-life balance, is the first step to health equity. Exercise comes hand in hand with healthy eating, and so encouragement to do simple activities like running, and advice on how to access local sports teams, would also ensure a healthy lifestyle.
Other areas that young people could be given more information are as follows:
- Finances – understanding of the tax system; how to save money; how to manage debt.
- Mental health – how to self-manage in periods of stress, low mood, anxiety etc; how to access services on offer if needed.
- Charity/volunteer work – promote a sense of giving to your community even with a working lifestyle.
- Pregnancy and parenting – planning life to support a family; maintaining a relationship; support networks available.
- Training – future planning for continuing education; planning a career path and social/family life.
- Housing – budgeting to be able to afford housing; schemes to support young professionals.
- Advice on substance misuse – services available to support individuals.
- Ill health – how and where to seek medical attention if needed.
From education to employment
Another difficulty faced by young people is the transition from education to working life. To address this, education services could work on empowering young people to make the most of local businesses and community groups.
Many young people face the challenge of finding connections between their education and work coupled with a lack of opportunities for future jobs. The education service can play a huge role in breaking down these challenges and social gradient barriers by integrating employment sessions into the curriculum where young people learn from local leaders and businesses, seeing them as role models for future career paths.
The Covid-19 pandemic has exposed the shortcomings in our Health and Social Care system in meeting the needs of the British people. It is important that the expected economic growth it is matched with investment in our public services.
Reducing health inequalities is found to be cost-effective. By empowering young people to control their lives, it creates an aspirational generation to live healthier lifestyles, reducing co-morbidities, and hence, the burden on NHS services. Policymakers must move to models where we invest in primary prevention measures and long-term strategy to address health inequalities.
This is the first of a three-part series by Hasnain Khan, looking at addressing health inequalities. Part two is entitled ‘creating aspiration and healthy working conditions’. Hasnain is a medical student at the University of Sheffield and was president of the Sheffield MedSoc 2020-21. He is the vice-chair of the Yorkshire Socialists Health Association, running ‘Rethink Healthcare’ policy workshops to shape regional and national health policy.
