Petra was invited to give evidence on health inequalities to the Scottish Parliament’s Health, Social Care and Sport Committee today.

21st June 2022

The Committee has been taking written and oral evidence as part of its inquiry into health inequalities in Scotland. In today’s session, Petra spoke about how health inequalities are strongly linked to inequalities in wealth and influence, and how so many of the systems (housing, welfare, education, food and healthcare) that impact on health inequalities are failing. Austerity, Brexit, the pandemic, war in Europe and the climate crisis have led to instability and uncertainty. She argued that high levels of inequality, poverty and an unhealthy population make Scotland much less resilient to these challenges.

Petra called for a whole government approach to reducing inequalities, with all government sectors agreeing to work together, including those who don’t currently consider inequalities or wellbeing in their portfolios.

Petra said: “We can only reduce inequalities in two ways: redistribute health, wealth and power. Or, hold the top constant and bring up the rear (levelling up). We need the conversation of how much we really want to reduce health and other inequalities. We all agree that the sheer scale of health inequalities is appalling and that there is nothing more precious than people’s lives. If we are serious then we need to work out where to redistribute and where to level up. But any conversation needs to take account of the enormous social, economic and environmental costs of not taking action on inequalities.”

Also providing evidence at this session were: Dr David Cawston (GPs at the Deep End), Professor Sir Michael Marmot (University College London) and Dr Shari McDaid (Mental Health Foundation).

The official report of the session will be available here once published, and the session can be viewed again now on Scottish Parliament TV.

New analysis of the UK Government’s “Levelling Up” white paper highlights gaps and missed opportunities to address health inequalities.

1st June 2022

Following publication of the UK Government’s “Levelling Up” white paper, a new analysis argues for a stronger policy response to address growing health inequalities across the UK.

The study, published in the BMJ, identifies opportunities, barriers and gaps in the white paper for tackling geographical health inequalities.

The analysis was led by researchers from SIPHER and SPECTRUM (Shaping public health policies to reduce inequalities and harm) – two consortia funded by the UK Prevention Research Partnership (UKPRP).

“Levelling Up” health

Published in February to a mixed reception, the “Levelling Up” white paper outlines the UK Government’s strategy for tackling the stark inequalities which exist between regions across the UK.

Health inequalities are shaped by social and economic factors, as well as commercial influences, and therefore must be addressed as part of a broader approach to tackling inequalities.

Whilst areas of the white paper demonstrate a shift to reframe reducing health inequalities towards addressing wider inequalities, these are limited.

Despite the inclusion of a specific target for reducing health inequalities within the white paper, the authors highlight that the proposed measures for achieving this target are limited to health promotion and diagnostics, which available evidence suggests are unlikely to be effective.

A missed opportunity

Unequal exposure to commercial determinants of health, for example the availability of tobacco and alcohol, are also key drivers of health inequalities. However, these receive limited attention in the white paper.

This is highlighted by the study as a missed opportunity, with previous evidence demonstrating the impact of alcohol in changing mortality rates across the UK.

Most importantly, as highlighted by others, the strategy lacks the crucial long-term public investment needed to drive change.

Overcoming the UK’s persistent health inequalities requires far bolder policy investments and actions to address inequalities in social determinants such as housing, employment and income.

Dr Rob Ralston, SPECTRUM Research Fellow and Study Lead: “Although an explicit acknowledgement of the links between social and economic inequalities and health inequalities is welcome, the white paper is frustratingly preoccupied with lifestyle behaviours and health gaps. This, coupled with the omission of commercial, social and political drivers of poor health, make it unlikely that the programme will generate the action needed to reduce the UK’s appalling health inequalities.”

Professor Kat Smith, SIPHER Co-Investigator and co-author: “The cost of living crisis means attempts to ‘level up’ are welcome. However, the lesson of post-reunification Germany is that reducing inequalities requires policies to achieve a fairer distribution of resources. This white paper lacks such proposals and, rather than focusing on wellbeing economics, instead persists with the idea that traditional economic approaches can somehow tackle the very inequalities these policy approaches helped produce.”

Dr Katherine Dunne, Programme Manager for the UK Prevention Research Partnership: “It’s fantastic to see this collaboration between two UKPRP consortia, highlighting the importance of a broad policy approach to improve population health and reduce health inequalities.”

Read more

Read the paper, available from the BMJ.

Petra appears on Episode 29 of the UofG Spotlight podcast to discuss her work on economic inequalities and health outcomes and the need for a system-wide view at tackling challenges of poverty, health and sustainability. The Spotlight podcast is co-hosted by Graeme Roy (Dean of External Engagement, Social Sciences College) and Kezia Dugdale (Director of the John Smith Centre and former Scottish Labour leader) and covers public policy and the political process – at a local, national and international level – through a Scottish lens. Petra appears at 01:13.

The Scottish Government are now recruiting a part-time Senior Knowledge Exchange Officer. This is a new and exciting post at the interface between SIPHER and the Scottish Government. SIPHER will deliver novel evidence of the costs and benefits of the complex, interlinked and long-term consequences of policy decisions. The Scottish Government will work with this evidence to identify opportunities to align policies across sectors and consider the potential to change the way major investment decisions are made. The successful candidate will be an excellent communicator who can listen, understand and translate between the Scottish Government and SIPHER.

This is a fixed term post for 23 months.

The closing date for applications is Thursday, 31st March.

View the job description.

Julian Cox and Greg Fell presented at the UKPRP Systems Science in Public Health webinar, which was held on 2nd November 2021. Julian spoke about the SIPHER Consortium and Greg gave a keynote on policy challenges and implications within the local authority sector. The webinar was attended by 142 people who joined from Amsterdam, Canada and all across the UK and Northern Ireland. You can find a recording of the webinar below.