Health must be part of the levelling-up agenda
Six months have now passed since the Prime Minister instructed us to stay at home. The threat from COVID-19 has been a stark reminder that our health is one of the most valuable things we have, as individuals. Our health has a direct impact on our ability to receive an education, to work and to enjoy life. And as a country, a healthy population is one of the nation’s most important assets: a vital input into a strong economy that improves people’s wellbeing, their productivity and ability to participate in society.
Times of economic transition offer opportunities as well as risks. As the government seeks to rebuild the economy post-pandemic and ‘level up’ UK regions, there is an opportunity to create more inclusive economies geared towards reducing inequalities and improving health. In turn, a healthier population should increase resilience to future health crises as well strengthen capacity to deal with political, economic and social change.
The links between health and the economy are strong across the course of people’s lives. Healthier children have better educational outcomes, which impacts productivity in adulthood A healthy working-age population contributes to economic prosperity, increasing productivity. Conversely, people who are living with poorer health have more limited opportunities to participate socially and economically and poor health has been estimated to cost the UK economy £100bn per year in lost productivity. The Health Foundation is supporting innovative research on the impact of health on the economy to improve our understanding of the complex links between them.
We also know that our health is not distributed evenly. Men living in the most deprived tenth of areas in England might be expected to live 18 fewer years in good health than men living in the least deprived. That pattern has been repeated during the pandemic. ONS statistics show that between March and July, those living in the most deprived areas of England were 2.2 times more likely to die of Covid-19 than those in the least deprived areas.
At the heart of this health gap is socio-economic inequality. Economic systems which allow or promote very high levels of economic inequality can increase health inequality, damage social cohesion and prevent society as a whole (and deprived communities in particular) from thriving. The ‘levelling-up’ agenda is much needed, but it can only truly succeed if there is a dual focus on social outcomes, such as health, as well as economic disparities.
An economy that puts the health and wellbeing of its population at the centre:
- Promotes social cohesion, equity and participation;
- Encourages access to products and services that are good for people’s health; and
- Is environmentally sustainable.
The Health Foundation’s recent report Using economic development to improve health and reduce health inequalities focuses on the opportunities for embedding health and wellbeing in economic development work.It is based on case study research undertaken with the RSA and Demos Helsinki and draws out key lessons for policy-makers at national, regional and local levels in the UK.
As the government decides how to build back better, the roadmap to economic recovery must focus on the needs of local places and local authorities have a critical role to play in both improving health and leading local economic development activities. Table A identifies six things that local areas can do to build more inclusive, health-promoting economies, building on real examples of places which have done this well.
Table A: Six things that local areas can do to use economic development strategies to build more inclusive and health promoting economies. | |
Lesson | Example from the case study research |
Building a thorough understanding of local issues with robust analysis of both routine and innovative data sources | The Inclusive Growth Diagnostic Tool from Scotland’s Centre for Regional Inclusive Growth |
Developing long-term visions for local economies that are good for people’s health, which are supported by strong local leadership | Plymouth City Council’s Plymouth Plan 2014– 2034 and the systems leadership provided by their Inclusive Growth Group |
Engaging with citizens to inform priorities and build momentum for action | Community involvement in the work and priorities of the Clyde Gateway regeneration programme in Glasgow |
Capitalising on local assets and using discretionary powers more actively to shape inclusive local economic conditions | Leeds City Region Enterprise Partnership’s efforts to capitalise on the city’s strong history in medical technology innovation and numerous academic and health care institutions. |
Cultivating direct engagement between public health and economic development actors and building alliances across sectors | Mutual responsibilities and joint posts in economic development and health in various levels of government in Scotland. |
Providing services that meet people’s health and economic needs together | Finland’s one-stop guidance centres, where people under 30 can access help on issues related to work, health, education and everyday life. |
At the Health Foundation, we are particularly interested in building cross-sector alliances and supporting the collection and analysis of new data sources. We want to support local areas to build more health enhancing economies and later this year will be launching a £1.7m funding programme (Economies for Healthier Lives) so local areas can test innovative approaches.
There is a moral, social and economic case to ensure recovery plans are geared towards reducing inequalities and improving health and we hope our funding can contribute to that agenda. Continuing with the status quo risks leaving the country vulnerable to future shocks.