One of the UK’s leading public health experts has attacked the Conservative government’s record on health inequality, expressing hope that the next government will “take the right steps” to tackle the problem.
Speaking as he launches a fund to tackle the link between economic deprivation and poor health, Sir Michael Marmot said he had been snubbed by the current government and wanted to see cuts to education and public services reversed.
Marmot authored a seminal 2010 review into the link between health and wealth, which found that people in more deprived areas had shorter life expectancies. Since that report, the UK has got worse on many measures including life expectancy, child poverty and long-term sickness.
The latest study by the Institute of Health Equity at University College London, which Marmot leads, has found that more than 1 million people in England died prematurely in the decade after 2011 owing to a combination of poverty, austerity and Covid.
A Unicef report found that the UK had the biggest increase in child poverty between 2010 and 2020 out of the world’s wealthiest nations, the 39 Organisation for Economic Co-operation and Development countries.
Marmot told the Guardian: “I’d like to see reductions in child poverty … improvement in our public services, reverse the cuts to education. The cuts to education over the decade from 2010 to 2020 were 8% per pupil.
“Why would you do that as a country? The cuts were more extreme in deprived areas than in non-deprived areas. I’d like to see all that change.”
He said he found Labour and the Liberal Democrats more responsive than the current government to the idea of tackling the social conditions that are the main causes of health inequalities.
“I’ve been more than happy to talk to the present government. They haven’t been very happy to talk to me … Let’s hope another government will want to take the right steps.” He noted that Labour’s health mission talked of “making England a Marmot country, tackling the social inequalities that influence health”.
There are nine “Marmot places” – where action is being taken to improve health and reduce health inequalities – across England and Wales including Coventry, Manchester, Leeds, Luton and Gwent. More than 40 local authorities have said they want to reduce health inequalities.
The Institute of Health Equity has set up a £3m health equity fund with the investment group Legal & General (L&G).
The fund, which opens for expressions of interest on 4 June, will support local initiatives to improve housing, education, employment and nutrition. It will finance up to 150 initiatives across the UK, up to £75,000 for each project. Projects could range from funding for schools in deprived areas to community programmes that address the social factors behind pressures on A&E services.
“This fund from Legal & General is a very positive initiative but it’s not going to reverse billions of pounds of cuts,” Marmot said. “We are realistic about that. If you’ve cut funding spending to local government by 34% over the decade, it’s not going to level up by itself but I hope to bring initiatives bubbling up, that scaled up could make a huge difference.”
The first tranche of money, £1m, is going to north-east England where, Marmot said, life expectancy had got shorter and inequalities bigger since 2010. “We’re not going to reverse the mass deindustrialisation of the 1980s … but trying to take initiatives locally, that may reverse some of that damage,” he said.
L&G and the institute have worked together since 2021 and argue that better health will also yield economic benefits such as increased productivity. They are talking to housebuilders and other companies that may want to become involved in the initiative.
Marmot said: “We want to encourage local initiatives, not to let central government off the hook, but to say, what can we do? What can local people do to break the link between poverty, funding cuts and worse health outcomes?”
