National Leading Health and Wellbeing Programme 2013/14

Post Marmot - Social Inequalities in Health and Wellbeing

Hilton York 7th November 2013

Dr Mike Grady.Principal Adviser.

Institute of Health Equity.University College London.

The CSDH – closing the gap in a generation

The Marmot Review – Fair Society Healthy Lives

Review of the Social

Determinants of Health and

the Health Divide in the

WHO European

Region

• Social justice• Material, psychosocial,

political empowerment • Creating the conditions

for people to have control of their lives

www.who.int/social_determinants

Key principles

Persistence of health inequities in Sweden

The health divide and health inequities, males

The widening of health inequities in the Russian Federation

Areas for action – emphasizing priorities

•The review grouped its recommendations into four themes

•Action is needed on•all four themes.

Themes from the review• Human rights ��• Resilience of individuals and communities -

empowerment is central • Every stage of the life course • Protect future generations from social and

economic inequities• Ensure intergenerational equity ��• Joined -up action is needed• Proportionate universalism

A. Give every child the best start in lifeB. Enable all children, young people and adults to maximise

their capabilities and have control over their livesC. Create fair employment and good work for allD. Ensure healthy standard of living for allE. Create and develop healthy and sustainable places and

communitiesF. Strengthen the role and impact of ill health prevention

Fair Society: Healthy Lives: 6 Policy Objectives

Michael Marmot

Provide universal good quality

Early years child careEducation

Work

Green spaces that I can use

Lack of interesting activities in winter

Poor local job

prospects

Poor street lighting and

uneven pathways

Recyclingfacilities

Soaring fuel bills and poor insulation

Affordable transport

Spending time with

my neighbours

What enhances my wellbeing and health

What is detrimental to my wellbeing and health

Affordable healthy

food

THE NEW SIMPLIFIED HEALTH AND SOCIAL CARE SYSTEM

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

HEALTH AND WELLBEING BOARD PRIORITIES 2013

Health and Wellbeing Boards: One Year on: Humphries R and Galea A: October 2013:Kings Fund London.

Health,Wellbeing and resilience• Evidence participation and improving life skills ameliorates impact of

health inequalities. (Bynner and Parsons 2006)

• Learning and skill development impact positively and fosters community action. “ I don’t know what makes other people healthy but I know what makes me healthier and that is being happy and having friends.” (Susanne)

• Social networks create the conditions in which people thrive“ I would say that people in the group have more confidence. At one poInt they would have been sat at home doing nothing ,now they are out and are involved. Once you get there it ‘s amazing to see how far you can go.” (Joyce)

Draft Big Lottery Fund National Wellbeing Evaluation. CLES and NEF 2013