1. Social gradient in health and vulnerability
Peter Goldblatt

2. - People are in vulnerable situations when they experience multiple processes of exclusion - Data on excluded populations are extremely hard to obtain

3. The review identified four broad themes in which action needs to be taken
The lifecourse – from before birth, through early years and education, employment, family building and at older ages.
In the wider society - social protection, vulnerability, minimum standards of living, gender equity, community engagement and empowerment, sustainable and equitable local environmental policies
The macro-level context - taxes and public spending priorities, , sutainable development plans
Systems to support a strategic approach to equity – local, regional and national partnership working, health care systems and transparent scrutiny of inequities and the strategies to address these.

4. Life expectancy and disability-free life expectancy (DFLE) at birth, males by neighborhood deprivation, England, 1999–2003 and

5. Expected years from birth with disability, males by neighbourhood deprivation, England, 1999–2003 and

6. Expected years from birth with disability, females by neighbourhood deprivation, England, 1999–2003 and

7. Percentage smoking by difficulties experienced in paying bills, 2012

8. Life-course pathway from early life origins to inequality in mortality mediated by smoking
Giesinger I, et al. J Epidemiol Community Health 2013

9. Psychosocial environment of work
Stress arises from:
Demand-control imbalance
Effort-reward imbalance
Organisational injustice
Employment precariousness

11. What enhances my wellbeing and health
What is detrimental to my wellbeing and health
What enhances my wellbeing and health
Lack of interesting activities in winter
Recycling
facilities
Green spaces that I can use
Poor local job prospects
Affordable
healthy
food
Poor street lighting and uneven pathways
Affordable transport
Here is an example of a ‘fictional’ citizen’s view on what ‘enhances’ and ‘frustrates’ their wellbeing and health. It is an example of looking through both an asset and a deficit ‘lens’.
Spending time with my neighbours
Soaring fuel bills and poor insulation

12. The Role of Health Professionals in Tackling Health Inequalities:
Workforce Education and Training
Working with Individuals and communities
NHS organisations - Working in Partnership
Workforce as Advocates

13. B. Primary and Community Care
Indicators of health care access, quality and outcomes - all stages of the patient pathway
A. Home
Primary care Supply
Primary Care
Quality
4. Preventable hospitalisation
3. Hospital waiting time
5. Repeat hospitalisation
B. Primary and Community Care
C. Hospital
7. Amenable Mortality
6. Dying in hospital
D. Die

14. Association between average performance and deprivation: preventable hospitalization

15. Health is a human right Do something Do more Do better Michael Marmot
Source: WHO Review of Social Determinants and the Health Divide in the European Region