Health Equity in England: The Marmot Review 10 Years On

UK life expectancy stalled at the same time as a decade of austerity. The 10 Years On Review, #Marmot 2020, confirmed a widening of health inequalities and set out the current cost to society of avoidable health inequalities (health inequities).

Background

Professor Sir Michael Marmot was commissioned by the British government to review health inequalities across England in 2010 (‘Fair Society, Healthy Lives’) following the publication of his World Health Organization (WHO) review ‘Closing the Gap in a Generation’ in 2008. Sir Michael has since chaired reviews for The WHO across Europe , the Americas  and the Eastern Mediterranean Region .

The ground-breaking reviews confirmed governments policies focusing on the health care system and individual behaviour change approaches are not hugely effective at reducing health inequalities. To improve health for everyone and reduce inequalities, action needs to be taken on the social determinants – the circumstances in which we are born, grow, live, work and age (causes of the causes of ill health). Yet a decade of austerity in the UK has seen drastic cuts to local government funding, which is tasked with funding the social determinants.

Health Equity in England: Marmot Review 10 Years On is the result of a collaboration between the UCL Institute of Health Equity (IHE) and the Health Foundation. The review will lay out how austerity has taken its toll on almost all areas of the SDH, from rising child poverty, a housing crisis, a rise in homelessness, people with insufficient money to lead a healthy life and resorting to food banks in large numbers, to the left-behind communities with poor conditions and little reason for hope.

In the ten years since the publication of The Marmot Review, health inequalities appear to be widening, and life expectancy increases have stalled.  We urgently need to reprioritise and take action on health inequalities.

This is why UCL Institute of Health Equity is working with The Health Foundation to examine progress in addressing health inequalities in England and to propose recommendations for future action.

• Published in 2010, The Marmot Review was a landmark study of health inequalities in England.
• While there has been progress in some areas since 2010, there is growing evidence that health inequalities are widening and life expectancy is stalling.
• The Institute of Health Equity is working with The Health Foundation to examine progress in addressing health inequalities in England and propose recommendations for future action.
• The new report, Health Equity in England: The Marmot Review 10 Years On, will be published in February 2020, on the 10-year anniversary of the original review.
• There are a number of related resources from The Health Foundation .

Watch: The Marmot Review 10 Years On

The Marmot Review: Fair Society, Healthy Lives was published in February 2010 and outlined the scale of health inequalities in England and the actions required to reduce them. The report highlighted the need to take action across the social determinants of health, and called for progress to be made on a clear set of policy objectives. However, life expectancy is stalling, after steady increases for the past 100 years, and health inequalities are widening.

The Health Foundation and the Institute of Health Equity are working together to examine how health inequalities have changed and what progress has been made on tackling the social determinants of health. The review, led by Professor Sir Michael Marmot, will recommend practical proposals for action at national, regional and local level by:

• assessing national and local actions on the social determinants of health
• considering how effective these approaches have been in improving health and reducing inequalities
• undertaking a ‘deep dive’ analysis into some aspects of the key social determinants of health, including in early years and education; work and income; and housing, places, and communities
• examining societal trends affecting health inequalities since 2010.

The specific areas of focus being examined as part of the review are: 

1. Overarching issues 

• Widening health inequalities
• Place and communities

2. Early years and education

• Good level of development in early years and GCSE attainment
• Child poverty

3. Work and income

• Quality of work 
• Minimum income 

4. Housing, places and communities

• Housing quality, affordability and supply
• Social isolation and loneliness

Find out more

For further information, please contact:

Tim Elwell-Sutton
Assistant Director of Strategic Partnerships, the Health Foundation
Tim.Elwell-Sutton@health.org.uk

Jessica Allen
Deputy Director, Institute of Health Equity
Jessica.allen@ucl.ac.uk