Marmot demands focus on inequality as cuts bite

Sir Michael was speaking to HSJ as a new set of figures showed that life expectancy in England was continuing to increase - but that health inequalities had widened in most council areas between 2007-9 and 2008-10.

Sir Michael’s groundbreaking review Fair Society, Healthy Lives published two years ago highlighted the role of social determinants in health.

He said that “any government” should take these on board. “I don’t think that we have seen the action in these areas that I would like to see,” he said,.

“The main thing that the government has had its eye on is the size of the deficit. I would say have an eye on the impact on people’s lives. One way we measure that in the short, medium and long term is the impact on health.”

But he would not be drawn on what would happen if government policies affected future years’ figures. “In the future there may well be red lights flashing but I am not going to predict.”

The figures produced by London Health Observatory for the UCL Institute of Health Equity - formerly the Marmot Review Team - showed that life expectancy increased by 0.3 years for both men and women but that inequalities in life expectancy between neighbourhoods increased by 0.1 years for men and remained stable for women. Of the 150 English council areas examined, inequalities in life expectancy increased for men in 104 areas and for women in 92.

The largest increase in inequality in life expectancy was in the London Borough of Merton (1.5 years) for men and in Middlesbrough for women (2 years). The largest decreases in inequality were in Tower Hamlets for men (1.9 years) and in Kensington and Chelsea for women (1.1 years).

As well as the data on life expectancy, the team also looked at early childhood achievement - where the percentage of children reaching a good level of development by age five increased from 56 to 59 - and the number of young people not in education, employment or training, which had decreased slightly.  

Sir Michael said: “While the indicators show improvements in many areas, this is not the time to start celebrating. Life expectancy continues to increase for most people, but inequalities in life expectancy persist between communities with different levels of deprivation.

“The task therefore remains to improve the health for the majority of the population if we are to level the social gradient – this must be the focus for the Coalition government if they are to reduce health inequalities.”