The latest Marmot Report “10 years on” makes dismal reading.
It shows that government has not prioritised health despite the concerning trends during the austerity years. Increases in life expectancy and years in good health have stalled for many. These trends show sharp inequalities: the more deprived the area the bigger the drop in life expectancy and years in good health.
Healthcare provided by the NHS only accounts for approximately 10% of a population’s health: https://www.health.org.uk/blogs/health-care-only-accounts-for-10-of-a-population’s-health. The other 90% of health is created through a social process that happens in people’s homes, neighbourhoods, workplaces and wider networks. The solutions lie outside the NHS even more than they do within it and it’s time public policy and fiscal management recognised this.
New NHS Alliance agrees with all of Sir Marmot and his team’s recommendations, but we would go further.
The Review emphasises that, to tackle inequality, our society needs to enable all children, young people and adults to maximise their capabilities and have control over their lives. At the same time, we must create and develop healthy and sustainable places and communities.
Now is the time to develop of a properly funded, cross-sector ‘Social Model of Health’ to improve health and reduce health inequalities in the community. This needs to be everyone’s job – all sectors and communities themselves – and it needs to have Health Creation at its core.
About Health Creation and the 3Cs
• To be well, people need sufficient Control over the circumstances of their lives, meaningful and constructive Contact with other people, Confidence to take action with others to make improvements. People who fall below the required threshold will struggle in life and experience worse health outcomes. Enabling people to increase our levels of control and confidence, through meaningful and constructive contact with others, keeps us as healthy and productive as possible.
It also helps tackle health inequalities. Control, Contact and Confidence are the 3Cs of Health Creation.
• See our Manifesto for Health Creation here: https://www.nhsalliance.org/wp-content/uploads/2018/11/A-Manifesto-For-Health-Creation.pdf
• This ‘Manifesto for a Health Creating Society’ to which New NHS Alliance is a signatory takes a broader approach that also makes a case for a ‘social model of health’: See https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31801-3.pdf and
Other recent New NHS Alliance documents setting out our position
• Manifesto for a New Government: https://www.nhsalliance.org/wp-content/uploads/2019/11/Get-Health-Creation-Done-a-New-NHS-Alliance-Manifesto.pdf
• Submission to the Prevention Green Paper which provides many examples of Health Creation in action: https://www.nhsalliance.org/wp-content/uploads/2019/12/NNHSA-submission-Prevention-GP-FINAL-for-website.pdf