Next UK government must have health equity at its heart, argues professor

With an election looming, the next government must have health equity at its heart to avoid more devastating and avoidable loss of lives, argues Professor Sir Michael Marmot in The BMJ today.

In an open letter to party leaders, he points out that 1.2 million lives were cut short between 2011 and 2020 in 90% of areas in England, as a result of avoidable social and economic inequalities.

The U.K. is now well below the EU average for how long people can expect to live in good health, he says. "The central plank of the next government must be to prioritize everyone's health by implementing policies we know will reduce health inequalities."

He explains that austerity and regressive funding cuts harmed health and worsened health inequalities well before the COVID-19 pandemic. Overall, the decade was marked by stalling life expectancy (declining for women living in the 10% most deprived areas).

What a tragic waste, he says, especially so given the Conservative/Liberal Democrat Coalition government was presented with a blueprint of what to do in 2010 in his review Fair Society, Healthy Lives—the recommendations endorsed by the then government.

Despite a lack of effective policies nationally, there has been local action to tackle health inequalities involving the NHS, businesses, and the community and voluntary sector, he writes, which is proving effective even in the face of rising poverty and financial cuts.

However, he calls for a national health inequalities strategy for action based on eight objectives, including giving every child the best start in life, creating fair employment and good work for all, tackling racism, discrimination and their outcomes, and pursuing environmental sustainability and health equity together.

He also urges party leaders to appoint an independent Health Equity Commissioner, establish a new cabinet-level health equity and well-being cross-departmental committee, and ensure every place and local government in the U.K. is set up and funded to prioritize equity of health and well-being.

In this election year, politicians must give us hope for a better future, Marmot adds in a linked opinion. His analyses show that the U.K. is a poor sick country with some rich healthy people. "We know what we need to do to create a fairer, healthier society, now we need politicians to act."