Significant health inequalities have been highlighted by a major UCL-led review – Fair Society, Healthy Lives. Moreover, the report has pointed out that premature illness and death affects everyone below the wealthiest tier of English society – not just the poor.
Professor Sir Michael Marmot concluded that people living in the most deprived neighbourhoods will, on average, die seven years earlier than people living in the richest neighbourhoods. Even more disturbing, people living in poorer areas not only die sooner, but spend more of their lives with disability – an average total difference of 17 years. The review also estimated the cost of health inequalities – highlighting productivity losses of £31 bn to 33 bn every year, lost taxes and higher welfare payments in the range of £20 bn to 32 bn per year and additional NHS healthcare costs well in excess of £5.5 bn per year. The review predicted an increase in the cost of treating the various illnesses that result from inequalities in obesity alone to rise from £2 bn per year to nearly £5 bn per year by 2025. Prof. Marmot described the inequalities as “unjust” and argued that the UK cannot afford inaction as “the economic and human costs are simply too high”. Given the stark inequalities, he also pointed out that the Government could not raise the age of retirement to 68, as proposed, since three-quarters of the country do not have disability-free life expectancy at this age. Recommendations included: national targets on life expectancy, a more “progressive tax system” (as the poor pay 38% of their income in tax compared with 35% for the richest), the development of standards for a minimum income for healthy living (i.e. the lowest amount people can live on to enjoy a long, healthy life), improvement to ill-health prevention, fair employment for all, and measures to give every child the best start in life. Commenting on the report, King’s Fund acting chief executive, Dr Anna Dixon, said: “This review makes a significant contribution to the debate on health inequalities. It is clearly the role of the NHS to help everyone improve their chances of living longer and healthier lives. But the health service cannot eradicate these inequalities on its own. The onus is on Government to address health inequalities as a cross-departmental issue and to support not just NHS efforts but programmes that address the wider determinants of health – like housing, working conditions and early childhood education.
