The opportunity to ‘level up’ the nation’s health


Investing in the conditions that improve people’s health – education and employment opportunities, housing, social networks, and healthy surroundings – will be an essential part of the pandemic recovery. Poor health is strongly linked with lower labour market participation, which carries a high financial cost and lost opportunity both to individuals and the state. In 2019, employment rates in the UK were 17 percentage points lower for people with long-term limiting health conditions. These conditions also reduce productivity, as people experience higher levels of sickness absence.

People’s health status also influences the age at which they can continue to make an economic contribution through work. Only half of men living in the most deprived tenth of areas in England report good health in their late 50s (well before retirement age), while in the least deprived tenth of areas it is not until their late 70s that a similar proportion report being in good health (well after retirement age) and a similar pattern exists for women. The economic costs associated with poor health add up: the total economic cost of lost output and health costs are estimated at around £100bn a year.

The government has set out an aim to level up the country, promising to increase prosperity, widen opportunity and ensure that no region is left behind. It is an ambitious agenda and action to ‘level up the nation’s health’ has been described as part of it, although specific plans are still in development. There is clear motivation for action, with Health Foundation polling showing that the public expect government to act on improving health and there is unparalleled public awareness of health inequalities following the pandemic. There is political motivation to act too: at the 2019 election, female healthy life expectancy in seats gained by the Conservative party was 4 years lower than in the seats the Conservatives held, and 6 months lower than in Labour held seats.

Our recently published COVID-19 impact inquiry showed that the UK did not have the resilience to respond to shocks, like the pandemic, partly due to poor underlying health. The difference between those with the best and the worst health in the UK widened in the years prior to the pandemic. These inequalities were brought to the fore during the pandemic and risk widening further following the significant impact on society and the economy. International comparisons indicate that the UK’s health is falling behind other comparable countries. This partly reflects the stalling of improvements in life expectancy, particularly in more deprived areas of the country. Unless steps are taken to permanently reverse this trend, we will be unable to truly level up or build resilience to respond to future shocks.

The Health Foundation and other organisations, including the Inequalities in Health Alliance, are making a strong case for further action to improve health and health equity. Independent and public accountability for action taken are important, but the government itself needs to seize the momentum and make the most of the opportunities posed by the recovery and levelling up agenda.

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