Health, Marmot 2020
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102 Terms
What happened to life expectancy in the most deprived communities between 2010 and 2020?
It fell for women in most deprived communities outside London and for men in some regions
What are social determinants of health?
The conditions in which people live and the inequities in power, money, and resources
Why is health not only determined by healthcare funding?
Social and economic conditions strongly shape health outcomes
What policies were associated with austerity after 2010?
Rising child poverty, closure of children’s centres, cuts to education funding, and increased precarious work
Are health inequalities inevitable?
No, they can be significantly reduced and avoided
Why are health inequalities considered a matter of social justice?
Because unfair social conditions create avoidable differences in health
How many Sustainable Development Goals relate to social determinants of health?
11 out of 17
What was the purpose of the Marmot Review (2010)?
To analyse causes of health inequalities in England and identify ways to address them
What major trend in life expectancy occurred after the Marmot Review?
Life expectancy declined in the most deprived areas, especially for women
What were the six domains recommended by the Marmot Review?
Early childhood, education and capability, fair employment, healthy living standards, healthy communities, and prevention
What does proportionate universalism mean?
Policies should be universal but with greater intensity for more disadvantaged groups
What does the social gradient in health mean?
Health improves stepwise with higher socioeconomic position
How did austerity affect health inequalities?
It worsened them
How much did UK government spending as a percentage of GDP decline between 2009/10 and 2018/19?
About 7%
How much did local government funding decline between 2009/10 and 2018/19?
About 77%
Which areas experienced the greatest spending cuts?
The most deprived areas
Were austerity cuts distributed equally across England?
No, the largest cuts occurred in the areas with greatest need
How many local authorities implemented Marmot Review ideas into strategies?
More than 75%
Which city declared itself a Marmot City in 2013?
Coventry
Why is community empowerment important?
It helps communities influence local health and wellbeing
What happened to life expectancy growth after 2010?
It slowed substantially
Which areas experienced the greatest slowdown in life expectancy?
Highly deprived areas
Which region of England has the highest life expectancy?
London
Which region has the lowest life expectancy?
The North East
What is health expectancy?
The number of years people can expect to live in good health
What relationship exists between deprivation and ill health?
More deprived groups spend a larger proportion of life in ill health
Why must policies reducing health inequalities be proportionate?
Because lower socioeconomic groups need more intensive support
Why must health policies also be universal?
To improve health across the entire social gradient
Why could raising the state pension age increase inequality?
Poorer people develop disabilities earlier and may benefit less from pensions
Which groups are most likely to receive a state pension before disability develops?
People in the least deprived areas
What is period life expectancy at birth?
The number of years a baby born in a given year could expect to live if current mortality rates continue
How much longer did people in the least deprived decile live compared to the most deprived in 2016–18?
9.5 years longer for men and 7.7 years longer for women
How did inequalities in life expectancy change between 2010 and 2018?
They widened
How did life expectancy trends differ between rich and poor groups after 2001?
Improvements were slower among the most deprived
How does life expectancy vary between regions?
It is highest in London and lowest in the North East
How much lower is life expectancy in the North East compared with London?
About 2.8 years lower
How do regional inequalities differ between affluent and deprived groups?
Affluent groups have similar life expectancy across regions, while deprived groups differ greatly
What does the steeper health gradient in the North East indicate?
Greater inequality between rich and poor
Which ethnic groups have the lowest life expectancy in England?
Pakistani and Bangladeshi groups
Which ethnic group has the highest life expectancy?
Non-British White groups
What is the ecological fallacy?
Assuming area-level statistics apply equally to individuals
What happened to healthy life expectancy after 2009/11?
It declined
How many years in good health did men and women average in 2015–17?
About 63.6 years
How large is the gap in healthy life expectancy between the most and least deprived local authorities?
About 12 years
How does disability-free life expectancy vary by ethnicity?
Ethnic minority groups generally have lower DFLE than White British groups
How have life expectancy trends differed internationally?
The UK experienced one of the slowest improvements among high-income countries
Which country had the greatest slowdown in life expectancy improvements?
The United States
What are “Deaths of Despair”?
Deaths linked to suicide, alcohol, and drug misuse
How are life expectancy declines often associated politically?
With major economic or political crises
What happened to mortality rates after 2011?
Mortality increased for some younger age groups
What is avoidable mortality?
Deaths that could be prevented through healthcare or public health interventions
How much higher is avoidable mortality risk in the most deprived groups?
About three times higher
How did avoidable mortality inequalities change after 2010?
They increased
Which group has the highest suicide rates?
Men in the most deprived communities
What relationship exists between income and suicide?
Suicide rates decrease as income increases
Which region has the highest male suicide rate?
The North East
What is the main conclusion about health inequalities since 2010?
Life expectancy improvements stalled while inequalities widened
What are the “causes of the causes” in health?
The social determinants of health
Why is child poverty important for health inequalities?
Early disadvantage has lifelong impacts on health and development
How many children were affected by poverty after 2010?
More than 4 million
Which children are most likely to experience poverty?
Children in workless or lone-parent families
Why are early years interventions important?
They are highly effective and reduce long-term inequalities
How are poorer children affected developmentally?
They have lower development and educational outcomes from an early age
How do poor children sometimes perform better in poorer areas?
They may feel less excluded and stigmatized than in affluent areas
What is one reason for London’s higher social mobility?
Improved outcomes for disadvantaged children
What is an Adverse Childhood Experience (ACE)?
Traumatic childhood events such as abuse, neglect, or household dysfunction
How does low SES relate to ACEs?
Low SES children are more likely to experience ACEs
How much adult illness is linked to ACEs?
About 30%
What happened to Sure Start funding after 2010?
It was significantly reduced and many centres closed
What positive effect did Sure Start have?
Fewer hospital admissions among participating children
How are childcare workers disadvantaged?
They are low paid, low status, and often rely on benefits
Why is investing in early years considered effective?
It reduces inequalities and improves long-term outcomes
How much do health inequalities cost the UK annually?
Tens of billions in lost productivity and tax revenue
What is the relationship between SES and educational attainment?
Higher deprivation is linked to lower educational achievement
How do school exclusions affect inequality?
Excluded children have much poorer educational and health outcomes
Which children are most likely to be excluded from school?
Children eligible for free school meals
What is off-rolling?
Illegal exclusion practices used to improve school performance statistics
How are austerity and youth crime linked?
Areas with larger spending cuts saw larger increases in knife crime
What happened to youth service funding after 2010?
It declined sharply
What characterizes good quality work?
Job security, adequate pay, support, and healthy conditions
How has employment changed since 2010?
More jobs became insecure, low paid, or zero-hours contracts
Why are zero-hours contracts harmful?
They create insecurity and negatively affect health
What happened to the number of zero-hours contracts between 2010 and 2018?
They increased from about 168,000 to 900,000
What criticism was made of the Work Programme?
It focused on helping easier claimants rather than the most disadvantaged
How has Universal Credit affected wellbeing?
It increased stress, debt, and insecurity for many claimants
What problem occurred with Employment and Support Allowance assessments?
Thousands died after being wrongly declared fit for work
Why is having enough money important for health?
It allows people to meet basic needs and reduce stress
How can poverty affect decision making?
Scarcity reduces mental bandwidth and long-term planning
How have wages changed since 2008?
Real wages stagnated or declined for many workers
What are the four components of wealth?
Property, financial wealth, pensions, and physical wealth
Why is wealth important for health?
It provides security and reduces stress
How unequal is wealth distribution in the UK?
The top three wealth deciles hold most wealth
What is fuel poverty?
Inability to afford adequate heating for a healthy home
How do cold homes affect health?
They contribute to excess winter deaths and respiratory illness
What is food insecurity?
Inability to afford nutritious food
How has food insecurity changed among low-income adults?
It increased substantially
Why do many people use food banks?
Low income, debt, benefit delays, and insecure work
How did Universal Credit contribute to food insecurity?
The five-week wait pushed many families into crisis
What effect does debt have on mental health?
It is associated with anxiety, depression, and other disorders
Why are welfare and debt advice services in GP surgeries useful?
Many people would not otherwise seek help