A programme for greater health equity for the next UK Government
Michael Marmot, Jessica Allen m.marmot@ucl.ac.uk
www.thelancet.com Vol 403 June 22, 2024
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01243-1/abstract?dgcid=raven_jbs_etoc_emailI found this article interesting – although it is aimed at the UK it has some very interesting international comparisons and its theme is universal. I also found it quite chilling as it, to a certain extent, reflects the situation when I moved to the North East to the Northern Region Strategy Team in the mid 70s. Although the hospital infrastructure in the North East is now excellent, perhaps the underlying social conditions in terms of preventative health education is not so.
To quote the article: “The UK is unhealthy, literally and metaphorically. Literally, since 2010, many health indicators have stopped improving, health inequalities are increasing between social groups and regions, and health for people who live in the most deprived areas is declining. Of course, the National Health Service (NHS) should be properly funded, but attention to the social determinants of health is vital. The principle of proportionate universalism should be applied to all policies aimed at reducing inequalities. Health follows a social gradient—the greater the deprivation of an area the higher the mortality rate and the worse the health. A policy of targeting only the people who are worst off misses people with social disadvantage and related health disadvantage who fall above the threshold of intervention.
Eight principles to prioritise health equity
• 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 a healthy standard of living for all
• Create and develop healthy and sustainable places and communities
• Strengthen the role and impact of ill-health prevention
• Tackle racism and discrimination and their outcomes
• Pursue environmental sustainability and health equity together”
These Marmot Principles are from the 2010 report Fair Society, Healthy Lives: the Marmot Review. Marmot M, Allen J, Goldblatt P, Boyce T, McNeish D, Grady M. Fair society, healthy lives: the Marmot Review. London: Institute of Health Equity, 2010.
https://www.instituteofhealthequity.org/resources-reports/fair-society healthy-lives-the-marmot-review/fair-society-healthy-lives-full-report pdf.pdf (accessed June 10, 2024)
