In 2021, the Institute of Health Equity (IHE) was commissioned by Champs: Public Health Collaborative and the Population Health Board of the Cheshire and Merseyside Health and Care Partnership to support work to reduce health inequalities through action on the social determinants of health and to Build Back Fairer from Covid-19.
IHE will provide added focus and priority to existing work on health inequalities in the sub-region and develop new momentum and recommendations for effective action in the context of the Covid-19 pandemic.
In late 2021, an interim report from Professor Sir Michael Marmot’s team at the IHE was published, with the final report expected to be published in spring 2022.
Led by Professor Sir Michael Marmot, the Marmot Review into health inequalities in England was published on 11 February 2010. It proposes an evidence-based strategy to address the social determinants of health – the conditions in which people are born, grow, live, work and age and which can lead to health inequalities.
It drew further attention to the evidence that most people in England aren’t living as long as the best off in society and spend longer in ill-health. Premature illness and death affects everyone below the top.
The report, titled ‘Fair Society, Healthy Lives’, proposes a new way to reduce health inequalities in England post-2010. It argues that, traditionally, government policies have focused resources only on some segments of society. To improve health for all of us and to reduce unfair and unjust inequalities in health, action is needed across the social gradient.
This report was followed up by Sir Michael 10 years later with criticism for the lack of progress in those 10 years and calling for a renewed need for decisive and determined action, with a concentration on the social determinants of poor health and the need for health equity at the centre of all decision-making.
Cities and areas that are already Marmot Communities or aim to be soon include Coventry and Greater Manchester. The underlying feature of all Marmot Communities is a determined and joint effort to true integration across of number of sectors in order to achieve six common goals, as set out in Sir Michael’s original report from 2010:
1. Give every child the best start in life
2. Enable all children, young people and adults to maximise their capabilities and have control over their lives
3. Create fair employment and good work for all
4. Ensure healthy standard of living for all
5. Create and develop healthy and sustainable places and communities
6. Strengthen the role and impact of ill-health prevention
Areas awarded Marmot Community status are those which can provide evidence that these six goals are seen throughout local policymaking and decision-making, and that improved health and reduced inequalities are at the centre of how the area develops approaches to early years, education and skills, transport, housing, places and spaces, and jobs and businesses.
In September 2019, a Cheshire and Merseyside vision for population health event was held with senior leaders from health and care. Professor Sir Michael Marmot spoke at the event, offering his expertise on the current state of health inequalities in the UK and worldwide, and what can be done to begin to decrease this gap, including developing ‘Marmot-friendly’ communities.
Both organisers and attendees of the event reached a consensus on key prevention priorities; it was also agreed that the sub-region would become what’s known as a Marmot Community.
Speaking in 2021, Professor Sir Michael Marmot said: “I am delighted to be working with Cheshire and Merseyside on the sub-region’s journey to becoming a Marmot Community. It is my belief that for this kind of work, integration across the sectors, not just the health and care system, is vital. The key social determinants of health often lie outside of the health and care system, and by having a cross-sector approach and working together with partners, we can make much greater progress and get more things done, instead of working in isolation.”