Concerns that austerity policies are reversing gains made to reduce health inequalities in England

A cross government strategy, in place from 1997 to 2010, appears to have reduced health inequalities between the most deprived areas in England and the rest of the country, finds a study in The BMJ.

However, since the strategy ended with the change of government in 2010, inequalities have started to increase again - and there are now concerns that current policies are potentially reversing these gains, say the researchers.

Between 1997 and 2010, the UK government introduced the English health inequalities strategy - a comprehensive plan to reduce health inequalities between the most deprived areas in England and the rest of the country by increasing social investment, particularly in more deprived areas and population groups.

Health inequalities are defined as the differences in health between groups at different ends of the socio-economic spectrum. For example, between wealthier and less affluent groups.

It was unclear whether the strategy did or did not have an impact on health inequalities.

A team of researchers at the University of Liverpool set out to investigate whether the strategy was associated with a decline in health inequalities, compared with trends before and after the strategy.

They analysed the gap in male and female life expectancy between the most deprived fifth of English local authorities and the rest of the country before (1983-2003), during (2004-12), and after (2013-15) the strategy.

Before the strategy, the gap increased at a rate of 0.57 months each year for men and 0.30 months each year for women. During the strategy period, this trend reversed and the gap in life expectancy for men reduced by 0.91 months each year and for women by 0.50 months each year.

Since the end of the strategy period, the inequality gap has increased again at a rate of 0.68 months each year for men and 0.31 months each year for women.

By 2012, the gap in male life expectancy was 1 year and 2 months smaller and the gap in female life expectancy was 7 months smaller than it would have been if the trends in inequalities before the strategy had continued.

This is the first study to analyse trends in health inequalities before, during and after the strategy, providing the first evidence that it may have reduced these inequalities, reversing a previously increasing trend, write the authors.

They point out that the reversal of the trend in health inequalities from 2012 could be related to the delayed effects of the 2008-09 recession, but say “a more likely explanation is that this is related to the reductions in public spending that occurred since 2010 as part of the government’s austerity programme.”

In conclusion, they say the strategy “may have reduced geographical health inequalities in life expectancy, and future approaches should learn from this experience. The concerns are that current policies are reversing the achievements of the strategy”.