Agenda item

Dr Heather Brown of Newcastle University will be in attendance to provide an overview of Health Inequalities following the nhsa’s publication of Health for Wealth – Building a Healthier Northern Powerhouse for UK Productivity.

Dr Heather Brown provided the panel with information relating to her publication Inequalities in Health and Wealth. During the presentation Dr Brown included some of the following points:

 

·         It was important to understand how inequalities in health and in economic position impacted on generational inequalities.

·         The study found that deprivation in the North East had been increasing in many places, especially as the North East had some of the most deprived communities in the country when examined at the Lower Super Output Area (LSOA) level. Indeed, just under half of all LSOAs in Middlesbrough were in the 10% most deprived in the country.

·         The impact of Covid was also an important factor in this area, with child poverty having risen to 31% from 29% in the North East due to Covid.

·         Brexit had also affected the North East more than other regions economically (other than Northern Ireland).

·         Some the reasons for the North East performing comparatively poorly included de-industrialization changing the geography of economic growth and employment as well as disinvestment in peripheral former industrial areas and the Austerity agenda.

·         In terms of Health Inequalities; the regional health divide has been widening in recent years. Mortality was now 20% higher amongst young people living in the North.

·         Earnings and economic activity were also 10% lower in the North East than the rest of England with high levels unemployment, economic inactivity and worklessness.

·         While its full impact was still being examined, the Covid-19 pandemic had had a detrimental impact on both child and fuel poverty.

·         This subject had been examined during three national government policy initiatives: 1991-1998 (Increasing Neo-liberalism); English Health Inequalities Strategy (1999-2010); and Austerity (2010-2017).

·         The research data utilized 5,000 household surveys encompassing 10,300 individuals. The survey also ran during the Covid-19 pandemic to understand its impact. The areas the research was interested in physical health and limiting long term health impacts. It also wanted to understand poor health on the productivity gap.

·         The research also looked at food insecurity which was defined as any person in a household unable to healthy and nutritious food or was hungry but did not eat.

·         Methodologically, statistical analysis employed decomposition to breakdown how much of the difference in the employment gap between the Northern Powerhouse and the rest of England can be explained by physical and mental health and a limiting long term health condition. It would also estimate the association between mental and physical health and a limiting long term condition and employment.

·         The key findings of the research showed there were regional differences on the role of health inequality policy on the influence of the family on young adult children’s health and wages. It also found Austerity had been worse in the North than the Rest of England. Mobility was increasing at a slower rate in the North than the rest of England.

·         Economically it was estimated that should the gap in health inequalities be closed this could equate to an additional £13 billion to country’s GVA.

·         The research also found that people with basic or no educational qualifications who were unemployed in April 2020; and had a disability were more likely to report all three measures of food insecurity.

·         Financial vulnerability explained half the likelihood of being food insecure.

·         Eligibility for free school meals, being furloughed and receiving help from grandparents explains approximately 30% of the likelihood of being food insecure.

·         The recommendations made by the research included those Local Authorities, Local Enterprise Partnerships and Health and Wellbeing Boards. It recommended that these should scale up family centred place based public health programmes to invest more in interventions that reduce social and environmental inequalities.

·         Local enterprise partnerships, schools and third sector organisations, should develop locally ‘tailored’ programmes for young people providing both health and employment support.

·         Local health services should identify at risk families and individuals at a time of disrupted health service delivery.

·         Recommendations for Central Government included improved health and social mobility in the North including increased investment in place based public health. There should also be increased generosity of benefits that would keep people out of health inequalities.

·         There should be increased investment in Northern Schools to reduce inequalities in educational attainment.

·         There should also be increased spending on economic growth and development in “left behind” communities.

·         There should also be targeted job creation in economically vulnerable areas.

·         There were several challenges to resolving the issue, namely Brexit and the potential constraints around economic growth, NHS staffing levels and uncertainties around local government budget settlements.

·         There were also concerns about lagging behind public health and prevention expenditure compared to treatment of existing conditions.

·         The Covid-19 Pandemic also presented considerable challenges.

·         Overall the research found that deprivation was rising in the North of England and that health inequalities were increasing between the North and the rest of England.

·         The research also found that Health and Social Mobility for families in the North of England increased during the Health Inequality Strategy Period but had been decreasing since Austerity was introduced in 2010.

·         Improving health in the North can reduce the employment gap and that investment was needed in education, public health, employment opportunities, and the NHS.

 

 

Clarification was provided about how economic productivity was measured; which included examining Gross Value Added (GVA) or the employment. In basic terms the Norther Powerhouse definition of the north of England was used as well as ONS information about economic activity per local authority area.

 

It was queried if free school meals had been affected since the introduction of Universal Credit in the sense that many children no longer qualified for it.

 

A Member queried if being a member of the Northern Powerhouse brought the promised benefits. It was clarified that this was difficult to quantify as there was significant heterogeneity in the north of England and that the Northern Powerhouse was more of a lobbying organization.

 

It was clarified for the panel that the research carried out was funded by the Northern Powerhouse and its methods and results were apolitical in nature.

 

It was commented that when external funding arrived in the North East it appeared it was directed at areas other than Middlesbrough, such as Newcastle. It was clarified that when funding was sought it should be on the basis of need. 

 

 

ORDERED:

 

1. That the question of how free school meals had been impacted by Universal Credit be raised with the service area.

2. That the information provided be noted.