Healthy Futures
Exeter,10th November 2010
Ilaria Geddes
University College London
Fair Society, Healthy Lives.
The Marmot ...
Key themes
•Reducing health inequalities is a matter of
fairness and social justice
•Action is needed to tackle the social...
POLICY OBJECTIVE A
Give Every Child the Best Start in Life
Policy Objective A
Recommendations
• Increase proportion of expenditure
allocated to early years
• Support families (pre a...
POLICY OBJECTIVE B
Enable all young people, children and adults
to maximise their capabilities and take
control over their...
Policy Objective B
Recommendations
• Continued priority to reducing inequalities
in education outcomes
• Prioritise inequa...
POLICY OBJECTIVE C
Create Fair Employment and Good Work for
All
Policy Objective C
Recommendations
• Prioritise active labour market
programmes
• Quality of jobs improved (equality
legis...
POLICY OBJECTIVE D
Ensure Healthy Standard of Living for All
Policy Objective D
Recommendations
• Minimum Income for healthy living
• Remove cliff edges
• Review taxation and welfare ...
POLICY OBJECTIVE E
Create and develop healthy and sustainable
places and communities
Policy Objective E
Recommendations
• Combining policies to mitigate climate
change and health (active travel, green
space,...
POLICY OBJECTIVE F
Strengthen the Role and Impact of Ill Health
Prevention
Policy Objective F
Recommendations
• Prioritise investment – up from 4% of NHS
budget
• Medicalise drug treatment
• Gradie...
Local Delivery and Indicators
• Framework for indicators
• Local practitioners want principles for action
rather than spec...
www.marmotreview.org
Fair society, healthy lives the marmot review   ilaria geddes
Fair society, healthy lives the marmot review   ilaria geddes
Fair society, healthy lives the marmot review   ilaria geddes
Fair society, healthy lives the marmot review   ilaria geddes
Fair society, healthy lives the marmot review   ilaria geddes
Fair society, healthy lives the marmot review   ilaria geddes
Fair society, healthy lives the marmot review   ilaria geddes
Fair society, healthy lives the marmot review   ilaria geddes
Fair society, healthy lives the marmot review   ilaria geddes
Fair society, healthy lives the marmot review   ilaria geddes
Fair society, healthy lives the marmot review   ilaria geddes
Fair society, healthy lives the marmot review   ilaria geddes
Fair society, healthy lives the marmot review   ilaria geddes
Fair society, healthy lives the marmot review   ilaria geddes
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Fair society, healthy lives the marmot review ilaria geddes

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  • Proportionate universalism: actions that are universal, but with a scale and intensity that is proportionate to the level of disadvantage.
    Economic growth is not the most important measure of a country’s success. The fair distribution of health, well-being and sustainability are important social goals.
    We were always told that our recommendations would be expensive, a comprehensive cost-benefit model of reductions in health inequalities does not exist. We calculated ‘the cost of doing nothing’: 1.3 to 2.5 million extra years of life; productivity losses of £31-33B; reduced tax revenue and higher welfare payments of £20-32B; increased treatment costs well in excess of £5B.
    Delivering the Review’s policy objectives will require action by central and local government, the NHS, the third and private sectors and community groups.
    Effective local delivery can only happen by empowering individuals and local communities.
  • - Components of the framework: life course, social determinants, health outcomes, including wellbeing.
    We have developed an indicators framework, including process, output and outcome indicators.
    Up to local practitioners to select targets after strategic needs assessment and prioritisation.
    Monitoring must be aimed at measuring the impact on the social gradient.
    - Locally appropriate plans through SCS, JSNA, LSPs, LAAs, CAAs
    Role of local government:
    - Opportunity to tackle cross-cutting issues through the Local Performance Framework
    - Well placed to lead on partnerships
    - Commissioner of Services
    - Democratic/community engagement
    - Community safety and place shaping (planning)
    - Could act as model employer
    - Provider of adult social care and children’s services, as well as leisure services.
  • Fair society, healthy lives the marmot review ilaria geddes

    1. 1. Healthy Futures Exeter,10th November 2010 Ilaria Geddes University College London Fair Society, Healthy Lives. The Marmot Review
    2. 2. Key themes •Reducing health inequalities is a matter of fairness and social justice •Action is needed to tackle the social gradient in health through ‘proportionate universalism’ •Action on health inequalities requires action across all the social determinants of health •Reducing health inequalities is vital for the economy, the cost of inaction •Effective local delivery requires effective participatory decision-making at the local level.
    3. 3. POLICY OBJECTIVE A Give Every Child the Best Start in Life
    4. 4. Policy Objective A Recommendations • Increase proportion of expenditure allocated to early years • Support families (pre and post natal, parenting, parental leave, transition points) • Quality early years and outreach
    5. 5. POLICY OBJECTIVE B Enable all young people, children and adults to maximise their capabilities and take control over their own lives
    6. 6. Policy Objective B Recommendations • Continued priority to reducing inequalities in education outcomes • Prioritise inequalities in life skills (whole child approach, full service schools, workforce) • Increase access and use of quality lifelong learning (16-25 yr old support, work based learning, non-vocational courses)
    7. 7. POLICY OBJECTIVE C Create Fair Employment and Good Work for All
    8. 8. Policy Objective C Recommendations • Prioritise active labour market programmes • Quality of jobs improved (equality legislation, well being, stress and mental health at work) • Security and flexibility of employment (retirement and people with poor health and caring responsibilities)
    9. 9. POLICY OBJECTIVE D Ensure Healthy Standard of Living for All
    10. 10. Policy Objective D Recommendations • Minimum Income for healthy living • Remove cliff edges • Review taxation and welfare system
    11. 11. POLICY OBJECTIVE E Create and develop healthy and sustainable places and communities
    12. 12. Policy Objective E Recommendations • Combining policies to mitigate climate change and health (active travel, green space, food environment, energy efficiency) • Integrate planning, transport, housing environmental and health systems • Regeneration based on reducing social isolation and remove barriers to action
    13. 13. POLICY OBJECTIVE F Strengthen the Role and Impact of Ill Health Prevention
    14. 14. Policy Objective F Recommendations • Prioritise investment – up from 4% of NHS budget • Medicalise drug treatment • Gradient in smoking, obesity and alcohol • Public Health - social determinants
    15. 15. Local Delivery and Indicators • Framework for indicators • Local practitioners want principles for action rather than specific recommendations • Develop locally appropriate plans • Develop local performance improvement framework • Systematic approach to engaging communities through the development of LSPs • Commissioning, employment, planning, adult social care and children’s services.
    16. 16. www.marmotreview.org

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