15 Sep 2021 Food Active joins call for cross-government action to reduce health inequalities
The Inequalities in Health Alliance today launch their ‘Inequalities in Health Position Paper’, calling for an explicit cross government strategy to reduce health inequalities. Health Equalities Group (HEG) are a member of the Alliance and fully support the recent letter written to the Prime Minister on this important topic.
As a nation we continue to experience widespread preventable illness and inequalities in health outcomes. Inequalities in health are unjust and avoidable yet they continue to persist. In parts of the UK the conditions for living life in good health are poor and continue to deteriorate. Furthermore, the impact of the COVID-19 pandemic has exacerbated inequalities and had a disproportionate effect on disadvantaged communities. It is acknowledged that wider action on prevention will help people to stay in good health and also moderate demand across the health and social care system.
Evidence suggests that wider determinants are the most important drivers of good health, with people’s lives strongly influenced by the socio-economic conditions in which they are born, where they live and go to school, and where they eventually die. An effective population-level health system is considered to be one that distributes effort across all pillars: wider determinants of health, health behaviours, an integrated care system, and there is growing recognition of the role of ‘place’ and communities.
Over the last seven years Health Equalities Group have developed a number of prevention frameworks with a particular focus on healthy weight that address the structural and environmental factors that can influence the health and well-being of local communities, to improve health and drive down inequalities.
The Local Authority Declaration on Healthy Weight: first launched in 2015, the Declaration presents an opportunity for local authorities to lead local action and demonstrate good practice in adopting a systems approach to healthy weight.
The Declaration is a statement owned by each adoptive authority, signalling a strategic commitment made across all council departments. Primary aims are to: reduce unhealthy weight in local communities; protect the health and wellbeing of staff and citizens; and, to make an economic impact on health, social care and the local economy. The Declaration includes commitments whereby Local Authorities pledge to achieve action on improving policy and healthy weight outcomes in relation to specific areas of the council’s work.
Since the transition of public health from the NHS into local authorities, councils are uniquely positioned to support a system-wide approach to promoting healthy weight. The functions which councils are directly responsible for can have a significant impact on the health of the communities they serve and their employees. However, making progress on improving healthy weight outcomes goes well beyond the remit of public health. A local authority level commitment, which encompasses planning, public health, environmental health, education, leisure and recreation, has the scope to impact significantly on the residents of a council area.
Examples of collaborative working across directorates and with external stakeholders can lead to progress in areas such as planning to consider recreational space, active travel, the food environment and supplementary planning to address proliferation of takeaways, procurement contacts for provision of food and drink and access to free drinking water across local authority controlled sites. If the causes of obesity are multi-factorial a whole-systems approach is key to improving the health of our populations.
Since 2015, the Declaration has been adopted by 25 councils across England, including districts, unitary and metropolitan authorities and counties. Many additional councils from the North West, North East, Yorkshire and Humber, South West and the South of England, together with the East Midlands region are currently working towards adoption of the Declaration. Evidence emerging from adoption of the Declaration is starting to demonstrate that a ‘local government declaration’ on healthy weight is an effective tool in bringing together a range of stakeholders and raising the profile of, as well as setting the agenda on, policies and practices promoting improved diet and physical activity.
The factors which present a barrier to good health for so many are often beyond the control of the individual. It is recognised that cross government working to address healthy weight and reduce inequalities must take place at all levels across society and in terms of government responsibility this ranges from national to local action. The Health Equalities Group are calling on the Prime Minister to support the development of a strategy to reduce inequalities, that considers the role of every department and every available policy lever in tackling health disparities.
COVID-19 has also brought the importance and urgency of addressing inequalities to the fore, it is therefore important for the government to deliver a national strategy upon which councils can take local action to ‘build back fairer’, supporting the development of healthier places, reducing inequalities and building resilience into recovery plans as part of the wider prevention agenda.
This article was prepared by our programme lead Nicola Calder.