Health inequalities strategies for action
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Health Inequalities: Strategies for Action. Dr Jessica Allen 21/9/11 www.marmotreview.org. English Review Further English work European Review Global network. Fairness at the heart of all policies.

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Health Inequalities: Strategies for Action

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Health Inequalities: Strategies for Action

Dr Jessica Allen

21/9/11

www.marmotreview.org


  • English Review

  • Further English work

  • European Review

  • Global network


  • Fairness at the heart of all policies.

  • Health inequalities result from social inequalities – requires action on all the social determinants; the causes of the causes

  • Focusing solely on the most disadvantaged will not reduce inequalities sufficiently – action is needed across the social distribution.


Fair Society: Healthy Lives:

6 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


Action in England

Local authorities

PCTs

National Government – public health white paper

Other government departments

Indicator - data


BUT

  • Health system changes

  • Lip service – lifestyle drift

  • Targets and indicators

  • Wider workforce

  • Health service predominates

  • money…


Marmot Review inter and intra LA data:

  • Life expectancy

  • Health expectancy

  • (Wellbeing)

  • Readiness for school

  • Young people not in education, employment or training

  • Income (after tax and benefits) sufficient for healthy living


Range of male life expectancy within local authorities: England


English publications

  • Fuel poverty – Health Impacts of cold homes

  • Barts and London workforce strategy

  • NHS Workforce – what NHS workforce can do to tackle SDH


Future work

  • What does a H & WB that takes SDH approach to Health inequalities seriously look like?

    • London Health Improvement Group

  • What does a CCG that takes SDH approach to health inequalities seriously look like?

  • What does a NHS workforce that takes health inequalities seriously look like

  • Acute sector?


EUROPEAN REVIEW OF SDH AND THE HEALTH DIVIDE

  • 53 countries of Europe

  • Description and analysis of evidence

  • Propose interventions at variety of levels

  • Propose delivery system

  • Intra governmental and NGOs, private sector, health system, local government, other stakeholders.


Life expectancy at birth by sex for countries in the WHO European Region, 2008

or latest available year: males

55 60 65 70 75 80 85

life expectancy at birth - males

European Review of Health Inequalities and the Health Divide


Life expectancy at birth by sex for countries in the WHO European Region, 2008

or latest available year: females

55 60 65 70 75 80 85

life expectancy at birth - females

European Review of Health Inequalities and the Health Divide


Life expectancy at age 15, men, 1970-2007

European Review of Health Inequalities and the Health Divide

From WHO Health For All database


Self reported good health by income quintiles: Latvia and Sweden

Percentage in good/ very good health

EU SILC 2008 data, Bradshaw & Mayhew personal communication 2010

European Review of Health Inequalities and the Health Divide


Emerging themes

  • adoption of human rights and asset-based approaches and societal approaches to well being.

  • organisations and governance are critical to successful action on the social determinants;

  • the need to intervene across the whole of the population – not just with the most deprived groups – with an intensity of action that is proportionate to need;

  • ensuring that actions taken are relevant across the diversity of countries in the WHO European Region;

  • recognising that empowerment of civil society is a vital ingredient of successful action;

  • the importance of global processes and influences and linking with the agenda for climate change; and,

  • the need to provide evidence on the social and economic costs of inequities.  


Consultation on European Review

  • To stimulate debate

  • To build further political support, policy alliances and capacity for a social determinants approach

  • Input is sought on the strategic conceptual approach developed so far by the Review

  • Additional, evidence and examples are sought of promising practice in tackling health inequities through action on the social determinants of health


Global Network

  • Rio

  • PAHO, EURO

  • Norway, Slovenia, England, Denmark, Sweden, Malmo

  • Chile - Ministry of Health review

  • Argentina - appointed a vice-Minister of Health with responsibility for health equity

  • Brazil - Commission on Social Determinants of Health

  • Costa Rica - implemented whole of government approach

  • Australia - an initiative from WHO and South Australia, the Adelaide Statement on Health in All Policies

  • The Asia-Pacific Network of HealthGAEN (Global Action for Health Equity Network) - a regional collective progressing the health equity agenda (14).

  • WHO Virtual global network


UCL Institute of Health Equity

Website www.marmotreview.org


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