Executive summary

This report sets out how economic development can be used to improve people’s health and reduce health inequalities in the UK. Its lessons are timely and relevant, with the coronavirus (COVID-19) pandemic showing us that people’s health and the economy cannot be viewed independently. Both are necessary foundations of a flourishing and prosperous society.

Health inequalities are growing in the UK. Since 2010, life expectancy improvements have slowed and people can expect to spend more of their lives in poor health. How healthy a population is depends on more than the health care services available to them – it is shaped by the social, economic, commercial and environmental conditions in which people live. Creating a society where everyone has an opportunity to live a healthy life requires action across government. While social protection measures – such as income replacement benefits, pensions, free school meals, social housing – are widely recognised as a core mechanism for reducing inequalities, the impact of structural inequalities in the economy itself has generally received less attention. This report contains case studies of economic development strategies which look beyond narrow financial outcomes as measures of success, and instead aim to enhance human welfare.

The evidence base in this field is at an early stage, but it already points towards people’s health and wellbeing being promoted by inclusive economies. This means economies that support social cohesion, equity and participation; ensure environmental sustainability; and promote access to goods and services which support health, while restricting access to those that do not. A wide variety of economic development interventions are available to local and regional bodies to create this kind of economy and the report examines these in detail.

An inclusive economies framework for improving health

This report provides a framework for practitioners to consider the interventions available and implement strategies most appropriate to their local situation. Local, regional and central government all have roles to play in shaping economies in ways that are beneficial for people’s health.

Based on the existing evidence base and the case studies developed for this report, we identify six areas that are important in facilitating local and regional approaches to developing inclusive economies:

  1. Building a thorough understanding of local issues – using robust analysis of both routine and innovative data sources, as in the case study on Scotland’s inclusive growth diagnostic tool.
  2. Leadership providing long-term visions for local economies – and designing these economies to be good for people’s health, as in the case study on Plymouth City Council’s long-term plans.
  3. Engaging with citizens – and using their insights to inform priorities and build momentum for action, as in the case study on the Clyde Gateway regeneration programme in Glasgow.
  4. Capitalising on local assets and using local powers more actively – as in the case study on economic planners’ efforts to capitalise on Leeds’ medical technology assets.
  5. Cultivating engagement between public health and economic development – building alliances across sectors, as in the case study on economic development and health in various levels of government in Scotland.
  6. Providing services that meet people’s health and economic needs together – as in the case study on Finland’s one-stop guidance centres for young people.

Cross-cutting lessons from local to national level

Four of the themes emerging from the case studies highlight the responsibilities that run across local, regional and national government and need to be embedded in thinking at every level of the system:

  1. Promoting economic conditions that recognise the needs of groups facing inequality – as in the case study on parental leave allowances in Sweden.
  2. Including health and wellbeing in the measurement of economic success – as in the case study on New Zealand’s Wellbeing Budget.
  3. Actively managing technological transitions and responding to economic shocks – with support for those most affected by structural shifts in the economy, as in the case study on Leeds City Council’s digital inclusion programme.
  4. Promoting standards of good work and wide labour market participation – as in the case study on tailored support to workers facing redundancy in Sweden.

Figure 1 demonstrates how economic development activity and the implementation of the report’s key recommendations could support improved health outcomes.

Figure 1: Simplified theory of change following implementation of this report’s main lessons

What next?

While there is ample evidence to act on now, the existing evidence base does need to be strengthened. But the challenge here is that economic development policies are linked to health outcomes often through long chains of events, which are difficult to study. Understanding what the potential health impacts of economic development policies are requires clarity on the mechanisms through which these policies influence people’s health. The Health Foundation is contributing to further developing knowledge in this field by supporting a funding programme called Economies for Healthier Lives in 2020.

This report is being published as we move into the next phase of pandemic recovery, with the government focusing on how to ‘build back better’. It also comes as the UK faces considerable economic challenges linked to Brexit, decarbonisation and technological transitions. With a focus on future economic resilience, there is an opportunity for government at all levels to embed health and wellbeing in economic policies. In doing so, policymakers should aim to reduce existing inequalities and prevent their further entrenchment.

In the short term, this research report recommends the government’s priorities should be:

  • Broadening the focus of economic policy beyond GDP to promote more inclusive and socially cohesive policies at a national level.
  • Ensuring that the COVID-19 response measures do not lead to a widening of the attainment gap in educational outcomes, which could exacerbate existing inequalities and hold individuals and communities back in the future.
  • Investing in lifelong education and skills development. Given the pandemic’s unequal impact on jobs and workers, this should mean focused investment in employment support and career guidance for young people entering the workforce, those in sectors facing the most financial instability and those who may need to change jobs due to being at higher risk of complications from COVID-19.
  • Introducing local and regional measures of equitable and sustainable economic development against which to assess progress in ‘levelling up’ opportunities across the country and between socioeconomic groups.
  • Targeting growth incentives towards sectors that contribute to sustainable development and growth in high-quality jobs and, in parallel, promoting better quality of jobs for workers in low-paid and insecure roles.
  • Devolving more investment funding for cities and local authorities, so that local strategic investments are fully informed by local context and investing in the capability and capacity of local enterprise partnerships to create inclusive economies.

All these actions need to be driven forward and supported with strong system leadership across the various levels of government. Their implementation would be best considered as part of a whole-government approach to improving health and wellbeing. Levelling up health outcomes needs a new national cross-departmental health inequalities strategy.

Times of economic transition offer opportunities as well as risks. There are opportunities to build economies that work better for everyone, enhance people’s health and reduce inequalities. The lessons from this report will support policymakers, researchers and changemakers in contributing to the action that is needed to do this.


Previous Next