Health Inequalities Debra Balfour Inequalities Lead Public Health 25 September 2014

2 Equality and Diversity The Equality Act 2010 protects people with particular characteristics from discrimination, bringing together all previous equality laws.

Equality Act 2010  Age  Disability  Gender reassignment  Marriage and civil partnership  Pregnancy and maternity  Race  Religion and belief  Sex  Sexual orientation 3

Equality Impact Assessments? (EIA’s)  A practical tool for identifying the potential impact of policies, services and functions on patients and staff  An equality impact assessment will help you analyse your policies and practices to make sure they do not discriminate or disadvantage people. EIAs also improve or promote equality. 4

Health Inequalities “There is a social gradient in health – the lower a person’s social position, the worse his or her health……People in poorer areas not only die sooner but spend more of their short lives with a disability.” Sir Michael Marmot Fair Society, Healthy Lives 5

The Commission on Social Determinants of Health (CSDH) – Closing the gap in a generation Strategic Review of Health Inequalities in England: The Marmot Review – Fair Society Healthy Lives Review of Social Determinants of Health and the Health Divide in the WHO European Region

Marmot Review – Fair Society, Healthy Lives  Give every child the best start in life  Enable all children young people and adults to maximise their capabilities and have control over their lives  Create fair employment and good work for all  Ensure healthy standard of living for all  Create and develop healthy and sustainable places and communities  Strengthen the role and impact of ill health prevention  8

Determinants of Health Source : Dahlgren and Whitehead

Determinants of Health Source : Dahlgren and Whitehead

‘Maslow’s Hierarchy of Need’ 12

Health and Social Care Act 2012  CCGs to have regard to the need to reduce health inequalities when exercising their functions and to set out in their annual commissioning plans how they intend to discharge this duty.  Public Health England has the same duty and a principle aim to reduce health inequalities.  NHS England must assess how well CCGs have discharged this duty. 13

Inequalities in Service Access and Take Up Source : London School of Economics and Political Science

Job Quality & Health  Job insecurity / temporary contracts  Adverse Psychosocial Work Environment  Shift work / extended work hours  Unemployment & Health

To tackle Health Inequalities  Every sector is a health sector – action across the whole of society can impact upon health.  Local Authorities, Health and Social Services, the Voluntary Community Sector, all have a key role to play at a local level.  Empower individuals and communities – create the conditions for people to take responsibility.