Marmot Review: Fair Society, Healthy Lives

Transcription

1 Marmot Review: Fair Society, Healthy Lives Professor Sir Michael Marmot Dying for Data Conference 30 th April 2014

2 The Commission on Social Determinants of Health (CSDH) Closing the gap in a generation Strategic Review of Health Inequalities in England: The Marmot Review Fair Society Healthy Lives Review of Social Determinants of Health and the Health Divide in the WHO European Region

3 Fair Society, Healthy Lives: 6 Policy Recommendations A. Give every child the best start in life B. Enable all children, young people and adults to maximise their capabilities and have control over their lives C. Create fair employment and good work for all D. Ensure healthy standard of living for all E. Create and develop healthy and sustainable places and communities F. Strengthen the role and impact of ill health prevention

4 Life expectancy and disability free life expectancy (DFLE) at birth: England

5 Public Health Outcomes Framework Vision: To improve and protect the nation s health and wellbeing, and improve the health of the poorest fastest Outcome 1: Increased healthy life expectancy, taking account of the health quality as well as the length of life Outcome 2: Reduced differences in life expectancy and healthy life expectancy between communities through greater improvements in more disadvantaged communities Note: These two measures are intended to work as a package covering both morbidity and mortality, addressing within-area differences and between area differences

6 Health and Social Care Act 2012 Legal duties to reduce health inequalities for the first time Public Health transfers to Local Authorities Health and Well Being Boards in operation Platform for joining up health services, social care services and health-related services at local level

7 Fair Society: Healthy Lives: some areas for concern A. Give every child the best start in life - Funding issues, child poverty B. Enable all children, young people and adults to maximise their capabilities and have control over their lives - Skills training, NEETS, whole school approaches C. Create fair employment and good work for all - Youth unemployment, contract workers, insecure employment, involuntary part-time working, ALMP policies D. Ensure healthy standard of living for all - Minimum income standard, minimum wages, benefit caps E. Create and develop healthy and sustainable places and communities - Green policies, social isolation, housing F. Strengthen the role and impact of ill health prevention - Cost inflation, resource allocation, demographic pressures

8 6.7 million of the 13 million people in poverty are in working households, UK 2011/12 (JRF 2013 using DWP data)

9 Report on impact of demographic change, recession and welfare reform on health inequalities in London and production of indicators to monitor and measure impact.

10 Recession indicators Piloted in 4 London boroughs Data now for available for all London boroughs These data will need to be supplemented by data that is only available locally

11 Published at 3 rd March 2014 Lambeth as example: profile of social determinants of health during the economic downturn Four domains: Employment Economic security Housing Health and well being

12 Employment: Lambeth compared with London & England averages

13 Unemployment (Institute of Health Equity 2014 using ONS data)

14 Job Seekers Allowance: claim of 12 months or longer (Institute of Health Equity 2014 using ONS data)

15 Young people (aged 16-18) not in employment, education or training (NEET) %16-18 year olds NEET England London Lambeth (Institute of Health Equity 2014 using DoE data)

16 Economic security: Lambeth compared with London & England averages

17 Working age benefits claims (Institute of Health Equity 2014 using DWP data)

18 Local Housing Allowance Claimants, June 2013 (and changes since April 2011)

19 Insufficient incomes Fall in collection performance of housing rents between April and May 2013 (Lambeth); Increase in rent arrears; 10% households in London in fuel poverty (2011 data)

20 Housing: Lambeth compared with London & England averages

21 Overcrowding % of overcrowded households England London Lambeth (Institute of Health Equity 2014 using DCLG data)

22 Children in temporary accommodation

23 Health and well being: Lambeth compared with London & England averages

24 Adults with depression % adults registered with a GP with a diagnosis of depression / / /12 England London Lambeth (Institute of Health Equity 2014 using ONS data)

25 Tuberculosis incidence Rate of new tuberculosis Cases per 100,000 population England London Lambeth (Institute of Health Equity 2014 using PHE data)

26 LOCAL ACTION: Local authorities 75% of local authorities have been significantly influenced by Marmot, evidence by their Health and Well-being Strategies and JSNAs (joint Strategic Needs Assessments) We have worked directly with 40 plus local authorities English Partnership Local government partnership between IHE and 7-8 local authorities until 2014/15 intensive working to develop SDH approach to health inequalities. Disseminate findings

27 60 Priorities agreed by 65 Health and Well-being Boards Local Government England Prevention Inequality Ageing Mental health Unhealthy behaviours Marmot Principles Kings Fund 2013

28 Do something Do more Do better Michael Marmot

29 UCL Health and Society Summer School: Social Determinants of Health July 2014 For further information