Introduction: Inequalities in Gateshead

In February 2020, Sir Michael Marmot published, Health Equity in England: The Marmot review 10 years on (Institute of Health Equity (Feb 2020). Health Equity in England: The Marmot Review 10 Years On.), in which he demonstrated that since 2010 life expectancy in England has stalled, something that has not happened since 1900.

In Gateshead we have seen our populations healthy life expectancy at birth slowing and in the case of female children, it is falling. Marmot says "the worsening of our health cannot be written off as the fault of individuals for living unhealthy lives. Their individual circumstances and poor life chances are to blame.

Austerity has taken its toll over the last 10 years, in the foreword to the report Marmot says "From rising child poverty and the closure of children's centres, to declines in education funding, an increase in precarious work and zero hours contracts, to a housing affordability crisis and a rise in homelessness, to people with insufficient money to lead a healthy life and resorting to food banks in large numbers, to ignored communities with poor conditions and little reason for hope ... Austerity will cast a long shadow over the lives of the children born and growing up under its effects." Marmot 2020.

Public funding cuts have had most impact on the most deprived communities outside of London and the South East and have accentuated the North South divide. Government funding for local authorities has fallen by an estimated 49.1% in real terms from 2010 to 2018. This equates to a 28.6% real-terms reduction in 'spending power'. (Local Government finance and the 2019 spending review.)

The COVID-19 pandemic has hit the country unevenly with a disproportionate effect on the North of England. In the 'Health for Wealth' report (2018), the Northern Health Science Alliance found that: improving health in the Northern Powerhouse would reduce the regional gap in productivity by 30% or £1.20 per-person per-hour, generating an additional £13.2 billion in UK GDP. However, the COVID-19 pandemic has vastly changed the regional context. (Bambra, C., Munford, L., et al (2020) COVID-19 and the Northern Powerhouse, Northern Health Science Alliance, Newcastle.)

Analysis by the Human Rights commission in 2018 shows that, overall, changes to taxes, benefits, tax credits and Universal Credit (UC) announced since 2010 are regressive, and that the largest impacts are felt by those with lower incomes. Those in the bottom two deciles have lost, on average, approximately 10% of net income, with much smaller losses for those higher up the income distribution. (Portes J, Reed H. (March 2018) The Cumulative Impact of Tax and Welfare Reforms. Equality and Human Rights Commission: 2018.) 

Poverty and health inequalities are placing an increasing demand on our services, so we need more than ever to focus our work and the money we have to spend, on what matters most. We want to help our communities not just survive, but to flourish, prosper and succeed.