Our latest Joint Strategy Needs Assessment (www.bhlis.org/jsna2013) highlights that life expectancy in Brighton & Hove is 77.7 years for males and 83.2 for females. Whilst females can expect to live, on average, six months longer than nationally, life expectancy for males is almost one year lower. Healthy life expectancy is 67.9 years for males and 72.9 for females, meaning that, on average, around 10 years of life are spent in ill health.
As has been seen nationally, whilst mortality rates in the city are falling in all groups, they are falling at a faster rate in the in the wealthiest 20% of the population, meaning that health inequalities are widening. The gap in life expectancy between the most and least deprived people in the city is now more than 10 years for males and six years for females, and similar inequalities also exist in healthy life expectancy.
Inequalities exist across the city in different areas such as education, employment, housing and income. These social determinants have many consequences including affecting the health and wellbeing of the population and individuals, either directly or through their influence on lifestyle choices or their effect on access to health services. Health inequalities such as the variation in life expectancy across the city are the result of these inequalities.
Therefore to improve life expectancy and health and wellbeing and to reduce health inequalities requires action to address the inequalities in the social determinants of health, as well as in preventive and treatment health services. Action to tackle these determinants of health and wellbeing are led within the partnerships covering these areas, for example the Strategic Housing Partnership and Transport Partnership. The respective chapters in the Sustainable Community Strategy will reflect action to influence health and wellbeing.
There are opportunities for short-term impact, such as improvements in the identification and treatment of those people at-risk of serious disease, and medium-term changes related to lifestyle. Many of the changes required for social determinants will have an impact in the future and should be considered as longer term interventions.
In 2010 the Marmot Review “Fair Society, Healthy Lives” into health inequalities in England provided an evidence based strategy to address the broader determinants of health and reduce inequalities. The report set six key policy and priority objectives:
- 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
The Review provides a framework for approaching inequalities within Brighton & Hove. Tacking Inequality is one of the three priorities in the council’s corporate plan for 2011-2015, and is also a duty of the Clinical Commissioning Group. The two other priorities in the council’s corporate plan; engaging people who live and work in the city and creating a more sustainable city; are also important to addressing inequalities.