Build Back Fairer in Greater Manchester: Health Equity and Dignified Lives

Commissioned by the Greater Manchester Health and Social Care Partnership this review, ‘Build Back Fairer in Greater Manchester: Health Equity and Dignified Lives’, includes bold and ambitious recommendations on how to reduce health inequities and build back fairer from the COVID-19 pandemic for future generations. A new Framework is part of the review and comes as life expectancy falls for everyone across the UK, and health inequities widen, at a cost of £39 billion every year. 

Marmot’s report shows life expectancy in north-west England fell in 2020 by 1.6 years for men and 1.2 years for women, compared with 1.3 years and 0.9 years across England as a whole. Within the region, life expectancy dipped most sharply in the poorer areas. Such a rapid decline was in life expectancy terms “enormous”, Marmot said.

Life expectancy had gone down all round the country but the degree to which people were affected depended on two things: level of deprivation and the region of the country in which they lived.

Covid-19 mortality rates varied within the region from around 400 males per 100,000 in the poorer boroughs such as Salford and Tameside to fewer than 250 per 100,000 in more affluent Trafford. For women they ranged from just under 250 per 100,000 in Manchester, to 150 per 100,000 in Stockport. Almost all local authority areas in the region had mortality rates above the England and Wales average.

Marmot called for a doubling of healthcare spending in the region over the next five years, as well as a refunding of local government, to tackle and prevent these inequalities and growing problems such as homelessness, low educational attainment, unemployment and poverty.

Future spending should prioritise children and young people, who had been disproportionately harmed by the impacts of Covid restrictions and lockdowns, and had experienced the most rapid increases in unemployment and deteriorating levels of mental health.

As well as damaging communities and harming health prior to the pandemic, funding cuts had “harmed local governments’ capacity to prepare for and respond to the pandemic and have left local authorities in a perilous condition to manage rising demand and in the aftermath of the pandemic”, the report said.

Even before the pandemic the UK had witnessed a stagnation in health improvement that was the second worst in Europe, and widening health inequalities between rich and poor. “That stagnation, those social and regional health inequalities, the deterioration in health for the most deprived people, are markers of a society that is not functioning to meet the needs of its members.”

The IHE’s Director, Professor Sir Michael Marmot, said “if the government is serious about levelling up health inequities, equity of health and wellbeing must be at the heart of government and business strategy rather narrow economic goals”.

A press release  and a briefing note are available to read and download.

The press release includes:  

• Comments from both UCL IHE Director, Prof. Michael Marmot and Mayor of Greater Manchester, Andy Burnham 
• A summary of the Key Recommendations from the new review: ‘Build Back Fairer in Greater Manchester: Health Equity and Dignified Lives’. 

Source: Greater Manchester Health and Social Care Partnership