This month, Marmot and colleagues published ‘Marmot Review 10 Years On’, looking at the health inequalities identified in their original review in 2010.

Health inequalities refer to the differences between people due to social, geographical, biological or other factors. Some differences, such as ethnicity, gender or age, may be fixed; whereas others are caused by social or geographical factors and can be prevented or lessened (such as social class). These differences can have a massive impact on people’s health, resulting in those worst off facing poorer health and shorter lifespans. Social and economic conditions can stop people changing health behaviours and may even reinforce health-damaging behaviours.

Looking at the original review, Fair Society, Healthy Lives (The Marmot Review), I have listed a summary of the 2010 findings:

The greatest influence on health inequality is social class.

• In England, people living in the poorest communities die 7 years sooner (on average) compared to people from the richest communities.
• They also live with disability for a greater proportion of their lives; a difference of 17 years (on average).
• There is a social gradient for health inequalities; the lower your socio-economic status, the poorer your health will probably be. The situation and conditions you are born into can lead to health inequalities – social inequalities lead to health inequalities.
• Health inequalities evolve from the complex interaction of many factors, including education, income, housing, diet, social isolation, and disability. These are all greatly affected by your socio-economic status.
• The Review asserted these health inequalities are generally avoidable.

So, have these health inequalities been addressed? This latest publication suggests not – health inequalities have reportedly widened. Key points from this latest review:

• For the first time in over 100 years, life expectancy in England has stalled.
• Life expectancy follows the social gradient; the more deprived the community, the shorter the life expectancy. Marmot states the social gradient has become steeper over the last decade, with inequalities in life expectancy becoming wider. For women in the most deprived areas, life expectancy actually fell.
• He also reported clear regional differences in life expectancy, particularly among people living in more deprived areas. He asserts that differences both within and between regions are typically increasing, with the largest decrease in life expectancy occurring in the most deprived communities in the North-East of England.
• Marmot also reveals that people spend more time in poor health compared to the 2010 Review.

A couple of commentaries can be found at RSPH and The Health Foundation

Marmot’s blog post is well worth a read in which he discusses the report, the last 10 years, and possible reasons for this worrying trend.