Professor Sir Michael Marmot shares his thoughts on how we all need to be involved in tackling the health gap.
Since 2010 life expectancy in England has stalled; this has not happened since at least 1900, says Sir Michael Marmot. If health has stopped improving it is a sign that society has stopped improving.
Health is repeatedly shown to be the nation’s top priority. And so it should be – it is quite simply a matter of life or death of wellbeing or sickness. Good health is an indication that society is thriving and that economic and social and cultural features of society are working in the best interests of the population.
The last decade has been marked by deteriorating health and widening health inequalities. People living in more deprived areas outside London have seen their life expectancy stalling, even declining for some, while it has increased in more advantaged areas.
For healthy life expectancy there has been little increase for men and a slight fall for women. This damage to health has been largely unnecessary.
There is no biological reason for stalling life expectancy and widening health inequalities. Other countries are doing better, even those with longer life expectancy than England.
The slowdown in life expectancy is not down to exceptionally cold winters or virulent flu, and cannot be attributed solely to problems with the NHS or social care – although declining funding relative to need in each sector will undoubtedly have played a role.
The increase in health inequalities in England points to social and economic conditions, many of which have shown increased inequalities, or deterioration since 2010.
In the 2010 Marmot Review, Fair Society Healthy Lives, we set out 6 areas, which covered stages of life, healthy standard of living, communities and places and ill health prevention.
These formed the basis for our six priority objectives and areas of recommendations:
• 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 a healthy standard of living for all.
• Create and develop healthy and sustainable places and communities.
• Strengthen the role and impact of ill health prevention.
Sir Michael Marmot is the director at the Institute of Health Equity, University College London.