Urgent action needed to tackle health and social care inequalities

Professor Sir Michael Marmot, Director of the UCL Institute of Health Equity is synonymous with the theme of health inequality in the UK. And this was the subject of his keynote address at the launch of the Institute of Public Health and Wellbeing. Sadly it revealed worrying trends.

How can we combat those trends? I believe our School of Health and Social Care offers solutions.

Health equity in England: The Marmot Review ten years on

In his 2010 report, 'Fair Society Healthy Lives', published in February 2010, Sir Michael called for immediate action to reduce the profound health inequalities in the UK and made six key recommendations.

Were we expecting to hear that significant change had been achieved in the years following this review? Maybe not, but what was not expected, I don’t think, from his latest research was the harsh reality, that not only had positive change not happened, but in fact the situation had significantly worsened in those ten years.

We heard how increases in life expectancy at birth, an expected and common finding across most other high-income countries, had in fact stalled in England, and that differences in life expectancy by deprivation widened across regions. We listened to how people can expect to spend more of their lives in poor health, with the health gap growing between wealthy and deprived areas. He reported how violence increased the most for those in more deprived areas, on the reductions in public health across England, and on a growing mismatch between need and funding.

The message was stark, the poor get poorer and the rich richer. And COVID-19 has only served to exacerbate further these inequalities.

Taking action - a call for one and all

So, what do we do to ensure positive change in another ten years, to mitigate against hearing or reporting on a review 20 years on with similar depressing and unacceptable findings? Sir Michael makes it very clear and simple in his final recommendation, take action.

Of course, he is addressing here the Prime Minister and government to lead urgent change. But I wonder if we should also be looking closer to home, at you and me.  As a collective, and certainly as a university, we cannot just sit by and expect change at government level, we need to advocate for this change, and more than that, make this change happen through research-informed education, evidence-based practice and methodologically rigorous and impactful research.

It is universities, is it not, who are the catalysts for empowerment and change, who destabilise the status quo and advocate for equality and inclusion? Universities are best-placed to challenge current practices and ideologies and the advent of the new Institute of Public Health and Wellbeing aims to do exactly this, promote health and wellbeing for everyone and reduce health inequalities.

Our transformational and high-quality educational programmes and research in the School of Health and Social Care target the very essence of Sir Michael's recommendations for change.

A framework for action - health and social care

Our mission as a School is to serve the local, national, and international communities through developing the highest quality health and social care professionals, and applied research that transforms practice, individuals, and communities.

We are committed to our founding principles of diversity and inclusion, social justice and social awareness, strong partnerships, impactful research, and co-production and citizen participation. It’s these principles that can bring about the change Sir Michael calls for.

Our education

Our education programmes in Nursing, Allied and Oral Health Professions, Psychological Therapies, Public Health and Social Work produces practitioners at the forefront of health and social care making evidence-based, fair, and equitable decisions; professionals who are equipped to challenge inequity and advocate for the most vulnerable.  

Our range of education programmes, and their recruitment and entry criteria are inclusive and ensure these opportunities are open to a diverse group of people. 

Our research

Our research is relevant, innovative, and improves the health and wellbeing of individuals and communities.

It spans the life cycle, starting with early child development and family support through the ‘A Better Start Southend (ABSS) project, which is transforming ways of thinking about services for very young children, and enhancing early development from infancy through to primary school transition.

We are exploring the lived experiences of marginalised groups too. For instance, through a five-year NIHR-funded Applied Research Collaboration (ARC) we are leading a project on engaging with Gypsy, Roma, Traveller and Showmen families in the east of England to understand more about the difficulties Travelling communities face in accessing health care.

Our research focuses on employment as well as education, with work undertaken supporting the long-term unemployed, and exploring fair employment and wellbeing through the investigation of menopause in the workplace.

Developmental and acquired cognitive and language impairments and dementia are within our sights too. Our researchers are involved in the development of clinical assessment, neuropsychological rehabilitation interventions and measurement of outcomes for people with developmental and acquired brain injury, while others are exploring care for the elderly, best practice in care homes, and the long-term care of people with dementia.

Nothing is left out, we are even helping to reduce the experiences of racism across clinical settings for staff, students, and service users and a number of projects are investigating the long term impact of COVID-19 on vulnerable and marginalised groups.

Co-production is the key

Our Health and Care Research Service helps us embed our research and consultancy services in to local, national and international health care organisations, social care bodies and voluntary sector organisations.

And our research is co-produced with our service users, co-ordinated through our School service user reference group, and those most impacted by the potential gains.

Reducing health inequalities is everyone’s business and is at the very essence of our education and research in the School. In the words of the anthropologist, Margaret Mead (1901-1978): “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.”