A question that has exercised so many of us, made more pressing by the impact of the covid-19 pandemic, is where will there be action on social determinants of health in order to improve health equity. We know the problem of health inequalities. At the UCL Institute of Health Equity, we are even confident enough to conclude that we have the evidence on what needs to be done, as laid out in our 2010 Marmot Review.
It would appear that, at a national level, the evidence has been overlooked. It is not fanciful to posit a link between failure to pursue policies on social determinants of health and England’s poor state of health before the pandemic. From 2010, the rate of increase in life expectancy slowed markedly; health inequalities increased, linked to deprivation and region; and life expectancy for the poorest people outside London declined. This worsening health picture, we suggest, is related to policies of austerity and regressive cuts to spending during that period...
... The Institute of Health Equity produced a national Build Back Fairer report, in December 2020. The evidence was that the status quo before the pandemic was not where the nation should be heading, given the relatively poor state of health. Build Back Fairer had recommendations of what needed to be done nationally, by government, business, the health and care system, and the voluntary and community sector.
Build Back Fairer in Greater Manchester, published June 30 2021, builds on our 2020 national report and makes recommendations that are concrete and can be put into action now.
At the national level The Institute continues to work closely with other cities and regions, including Coventry, for which a city evaluation was produced in 2020. We have begun programmes of work with Cheshire and Merseyside, Cumbria and Lancashire and other local authorities in England.
Further, in May 2021 The Institute also published a commentary report on UK ethnicity and mortality statistics in relation to the COVID-19 pandemic.
Internationally The Institute has responded to COVID-19 in the context of Health Equity and the Social Determinants of Health in:
- the Eastern Mediterranean Region with Build Back Fairer: Achieving Health Equity in the Eastern Mediterranean Region - The WHO EMRO Commission on the Social Determinants of Health, published on 31 March 2021.,
- in Hong Kong, with the first report in a series from our collaboration with the Chinese University of Hong Kong's Institute of health Equity: Build Back Fairer: Reducing Socioeconomic Inequalities in Health in Hong Kong published 16 November 2021
- and by collaborating with the WHO to produce an evidence brief; Equity, COVID-19 and the Social Determinants of Health (SDH), which discusses the disproportionate impacts that the COVID-19 pandemic is having on more disadvantaged population groups, with a focus on how it is widening health inequities.