Fair Society, Healthy Lives The Marmot Review of Health inequalities in England post 2010

1. Fair Society, Healthy Lives The Marmot Review of Health inequalities in England post 2010

2. Review Tasks The Review had four tasks • Identify, for the health inequalities challenge facing England, the evidence most relevant to underpinning future policy and action • Show how this evidence could be translated into practice • Advise on possible objectives and measures, building on the experience of the current PSA target on infant mortality and life expectancy • Publish a report of the Review’s work that will contribute to the development of a post-2010 health inequalities strategy

3. Cost of health inequalities in England • Between 1.3 and 2.5 million years of life lost • Losses from illness associated with health inequalities • productivity losses of £31-33B • reduced tax revenue and higher welfare payments of £20-32B and • increased NHS treatment costs well in excess of £5B.

4. Key Themes • Action is needed to tackle the social gradient in health – Proportionate universalism • Action on health inequalities requires action across all the social determinants of health • Reducing health inequalities is vital for the economy – cost of inaction • Beyond economic growth to well-being

5. Action across the life course

9. Six Policy Objectives • 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 healthy standard of living for all • Create and develop healthy and sustainable places and communities • Strengthen the role and impact of ill health prevention

10. A) Give every child the best start in life. • Priority objectives • Reduce inequalities in the early development of physical and emotional health, and cognitive, linguistic, and social skills. • Ensure high quality maternity services, parenting programmes, childcare and early years education to meet need across the social gradient. • Build the resilience and well-being of young children across the social gradient.

11. Evidence- early years

12. B) Enable all children, young people and adults to maximise their capabilities and have control over their lives. • Priority objectives • Reduce the social gradient in skills and qualifications. • Ensure that schools, families and communities work in partnership to reduce the gradient in health, well-being and resilience of children and young people. • Improve the access and use of quality lifelong learning across the social gradient.

14. C) Create fair employment and good work for all. • Priority objectives • Improve access to good jobs and reduce long-term unemployment across the social gradient. • Make it easier for people who are disadvantaged in the labour market to obtain and keep work. • Improve quality of jobs across the social gradient.

16. D) Ensure healthy standard of living for all. • Priority objectives • Establish a minimum income for healthy living for people of all ages. • Reduce the social gradient in the standard of living through progressive taxation and other fiscal policies. • Reduce the cliff edges faced by people moving between benefits and work.

18. E) Create and develop healthy and sustainable places and communities • Priority objectives • Develop common policies to reduce the scale and impact of climate change and health inequalities. • Improve community capital and reduce social isolation across the social gradient.

20. F) Strengthen the role and impact of ill-health prevention. • Priority objectives • Prioritise prevention and early detection of those conditions most strongly related to health inequalities. • Increase availability of long-term and sustainable funding in ill-health prevention across the social gradient.

21. Our pledges to theEast of England A better patient experience Improving people’s health Reducing unfairness in health Working with our partners, we will reduce the differences in life expectancy between the poorest 20% of our communities and average in each PCT We will ensure fewer people suffer from, or die prematurely from, heart disease, stroke and cancer We will deliver year on year improvements in patient experience We will extend access guarantees to more of our services We will make our health service the safest in England We will ensure healthcare is as available to marginalised groups and looked after children as the rest of us We will ensure that GP practices improve access and become more responsive to the needs of all patients We will improve the lives of those with long term conditions We will cut the number of smokers by 140,000 We will ensure that NHS primary dental services are available locally to all who need them We will halt the rise in obesity in children and then seek to reduce it

22. GO – East Goals • Build cohesive, empowered and active communities where people feel safe, confident and healthy • To address inequalities by supporting partners in narrowing the gap and raising aspirations • To support partners in promoting the health and wellbeing of everyone in the region • To ensure effective planning for growth and support the delivery of appropriate development and infrastructure • To promote economic prosperity in the region and ensure a comprehensive regional recovery from recession • Support the region in moving to a low carbon economy • To ensure that the region protects, enhances and benefits from its natural and cultural assets and that it plans for environmental change

23. Other areas of activity \ influence • Local Area Agreements • Comprehensive area assessments • World Class Commissioning • Place based working • Alcohol Harm Reduction • Change 4 Life • Tobacco Control • NHS prevention • Employment and Health • Health and the built environment

24. Regional Role

25. Local Government role

26. How do we implement Marmot ? • Provide the evidence – accessibly (miniature East of England ?) • Promotion and advocacy – across agencies and programme boards • Share good practice and innovation • Ensure evidence based evaluation • Health inequality \ equity assessments • Regional structures, roles, coordination and governance • Staying Healthy Board, Children’s Board • Regional Strategy Board- Social and Community Delivery Implementation Board • PSA Boards

27. Case Studies • Liverpool Fire and Rescue Service • Green Nephrology Service • Health Trainers in criminal justice system • North East Essex – Financial Advice Service