If you think inequality does not matter, think again

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If you think inequality does not matter think again. It does. It’s quite literally a matter of life and death as a major University College London led review shows.

The review — Fair Society, Healthy Lives — proposes new ways to improve everyone's health and reduce inequalities that it describes as 'unfair and unjust'.

The Government asked Professor Sir Michael Marmot (UCL Epidemiology & Public Health) to conduct the independent review. It concluded that, although health inequalities are normally associated with the poor, premature illness and death affects everyone below the wealthiest tier of English society.

People living in the most deprived neighbourhoods will on average die seven years earlier than people living in the richest neighbourhoods. Even more disturbing, people living in poorer areas not only die sooner, but spend more of their lives with disability — an average total difference of 17 years. The review has estimated the cost of health inequalities in England:

  • Productivity losses of £31 — 33 billion every year
  • Lost taxes and higher welfare payments in the range of £20 — 32 billion per year
  • Additional NHS healthcare costs well in excess of £5.5 billion per year

The review also predicts an increase in the cost of treating the various illnesses that result from inequalities in obesity alone to rise from £2 billion per year to nearly £5 billion per year by 2025.

The review calls for health inequalities to sit alongside tackling climate change as one of society’s core priorities. Creating a sustainable future is, the review argues, compatible with action to reduce health inequalities: sustainable local communities, active transport, sustainable food production, and zero carbon houses will all have health benefits across society.

The six main recommendations of the review are:

  • Giving every child the best start in life
  • Enabling all children, young people and adults to maximize their capabilities and have control over their lives
  • Creating fair employment and good work for all
  • Ensuring a healthy standard of living for all
  • Creating and developing sustainable places and communities
  • Strengthening the role and impact of ill-health prevention

Professor Marmot, whose commission included the President of the Royal College of Physicians, Professor Ian Gilmore, and the Chief Executive of the Economic and Social Research Council, Professor Ian Diamond, said: "There will be those who say that our recommendations cannot be afforded, particularly in the current economic climate. We say that it is inaction that cannot be afforded, the economic and more importantly human costs are simply too high.

It’s disappointing in a way that we need such a review to state what should surely be obvious. And yet to for too many — especially on the right and libertarian wings of politics — there is outright denial on this issue. Their indifference to fellow human beings is staggering.

The case for reform of society is not just ethical — it’s based on hard facts that only the wealthiest can deny. Well, they can, but it’s our job to make sure they pay for reform none the less.


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