Some sections of society have poorer health than others. Most strikingly, people from the most affluent areas of the country will have almost 20 more years of healthy life than those in the most disadvantaged areas. This is a central concern for public health professionals and indeed, reducing these health inequalities was enshrined as a core element of Public Health England’s role when it was established in 2013.
Many great examples of successful interventions to reduce these inequalities at a local level exist across England and beyond and we wanted to bring them together as a practical resource for public health professionals to use in their work.
This September, Professor Sir Michael Marmot and Professor Kevin Fenton launched the Local Action on Health Inequalities: evidence papers, which can be found on the PHE website and are freely available to all.
This launch was particularly timely as last week Professor Sir Michael Marmot’s Institute of Health Equity at UCL released its report on the latest figures on the Marmot indicators of health equity.
The headlines focussed on the fact the figures showed that nearly half of all children in England are falling short of developmental and educational milestones set by the Department for Education, with children from more deprived backgrounds performing worst.
We know that good child development is hugely important in a range of ways, not just in the early years but throughout life, in terms of improving people’s chances of maximising skills, getting good jobs and securing the income to live a healthy life.
Successful early intervention
Our briefings provide good examples on interventions to support child development and reduce these inequalities, through good quality parenting programmes, and by smoothing the transition from home to school.
The quality of parenting affects children’s long-term physical, emotional and social development and there is evidence that a range of parenting programmes designed for families with children of a particular age are effective, as part of wider measures to support parents.
Some areas have been supporting early intervention parenting programmes for a long time. For example, Tower Hamlets, Wandsworth and Kingston on Thames have had multi-agency systems in place for many years and successes have been reported by international programmes like the HIPPY programme, to help parents teach young children at home, and Families and Schools Together.
These are just a few illustrative examples on early intervention and more are provided in the evidence review on the PHE website.
Interventions as people get older
These early interventions can have a massive impact on the rest of someone’s life and health. We also have a duty to reduce inequalities throughout life and our Local Actions Briefings give successful examples of just that.
For example, Marmot has always stressed the huge impact of young people who are not in employment education or training (NEET). Being NEET at a young age is associated with poorer physical and mental health and impacts on a number of outcomes later in life, like unhealthy behaviours or involvement in crime.
Our NEET briefing paper highlights a number of interventions that have been established to help reduce this, with some success. Last week’s Marmot report showed that at the end of 2013, 16.4% of young people aged 19-24 were NEET, a fall from 18.4% in 2010.
Our papers go on to describe successful interventions for a number of areas that affect people through the life course, like adult education, fuel poverty and especially through work and employment. While I haven’t been able to go into them in detail here, we will examine them in future PHE blogs and communications.
In the meantime please see below for the full list of briefings (full evidence reviews are also available for each area) and feel free to use and share them with colleagues across public health, the third sector and local community.
- Good quality parenting programmes
- Improving the home to school transition
- Building children and young people’s resilience in schools
- Reducing the number of young people not in employment, education or training (NEET)
- Adult learning services
- Workplace interventions to improve health and wellbeing
- Working with local employers to promote good quality work
- Increasing employment opportunities and retention for people with a long-term health condition or disability
- Increasing employment opportunities and retention for older people
- Health inequalities and the living wage
- Fuel poverty and cold home-related health problems
- Improving access to green spaces
- Understanding the economics of investments in the social determinants of health