In November 2008, just after we published the Report of the WHO Commission on Social Determinants of Health Closing the gap in a generation, the Secretary of State for Health in
asked us to review health inequalities policies post 2010. The stimulus for doing this was two fold. First, the then Secretary of State, Alan Johnson, asked how the recommendations of the WHO report could be applied to England . Second, although health had improved for everyone in England over the last decade, health inequalities have not narrowed. England
At the end of 2008, I assembled a team of commissioners, with expertise in a range of areas and commissioned academics to report back on the latest research in nine areas which shape health. All of these task group reports are available on our website.
Our report, Fair Society, Healthy Lives, will be launched to the media on 11 February, with a conference held in
the following day. The report will be available on this website on 11 February. The report presents a strategy, based on the most recent evidence, to reduce health inequalities through a series of policy and delivery system recommendations. London
Our research seeks to move health inequalities’ policy in a new direction. To date, policy tends to have focussed on improving health for the worst off. We describe, however, how everyone has worse health than those at the top of the social economic scale – this produces a social gradient in health.. Policy has to address the whole gradient to reduce inequalities, not just those at the bottom. We also describe how health inequalities relate to wider social inequalities – in education, income, the built environment, communities, working conditions – these are the social determinants of health. We also make clear that reducing health inequalities is not only a job for the health sector. health inequalities should also be addressed in the early years, at primary and secondary schools, at work, in our communities and at home.
Commonly, I am asked: what is the one thing that I can recommend. Our report demonstrates that there is not one solution to reducing health inequalities. Recommendations are made that are relevant for local authorities, nursery staff, teachers, employers, planning, housing and transportation departments, as well as the NHS. Our report also sees the Department of Health as one of many government departments who can influence health inequalities. Many government departmentshave important roles and we have held meetings over the past year to discuss them.
Our work will continue after we publish the final report. Over the next year we will continue to work with the Review’s two regional partners: the Northwest of England and
, to help them implement our recommendations. We are also working with the NHS Institute for Innovation and Improvement and the Department of Health on the Healthy Places & Healthy Lives programme. London
Fair Society, Healthy Lives is a starting point not the end goal. Reducing health inequalities requires a social determinants approach to be championed and increasingly adopted as the way forward. The long-term success of reducing health inequalities depends on all of society working together – we provide answers, just a new direction in which to go.