Health inequalities and the role of local infrastructure

As our members increasingly move into the realm of health and wellbeing in communities (for example, social prescribing, Covid-19 response and Health and Wellbeing Alliance work), we took the opportunity to delve into the subject further at one of our learning lunches.

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Here at NAVCA, we think it's important to take a step back from our busy schedules to spend time together as a team, whilst learning something new that will help us with our work. That's why we've been holding regular learning lunches - during our lunch hour, we eat together (whether in person or online!), and learn more about a particular topic. This month, Anne-Marie, our Health and Wellbeing Manager, talked through the basics of health inequalities and how this affects our work supporting local infrastructure organisations in the voluntary and community sector.

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Health inequalities are avoidable, unfair and systematic differences in health between different groups of people. We know from 'Health Equity in England: The Marmot Review 10 Years On' that, in the ten years since Michael Marmot's original report, most measures of health inequalities have worsened. For example, 'the health gap has grown between wealthy and deprived areas' and 'place matters – living in a deprived area of the North East is worse for your health than living in a similarly deprived area in London, to the extent that life expectancy is nearly five years less'. Furthermore, people living in our most deprived communities, compared to those in our least deprived, have a gap in life expectancy of ten years in some areas. The Guardian also reported recently that the average life expectancy for all women across England and the UK is lower than the global OECD average, with differences between the poorest and wealthiest areas particularly significant.

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We now have Levelling Up and other responses to the entrenched health inequalities that came to the fore during the pandemic. There are many national, regional and local charities that are focused on work that improves health outcomes and reduces health inequalities. So, how can we, in our role of supporting local infrastructure, add value to this? How do we make a difference? The wider determinants of health are a diverse range of social, economic and environmental factors which we know influence people’s mental and physical health, best understood at a local level by people and organisations that know the nuances and cultures of individuals and communities. Therefore, our aim is to keep the focus on communities, and how better than supporting our members who are working directly with individuals affected by these factors in our communities?

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Local infrastructure organisations have a huge role to play in reducing health inequalities. From connecting people experiencing loneliness and isolation to a community project where they can volunteer, to sharing vital knowledge about local communities with the NHS and other statutory bodies, and supporting communities to mobilise and respond to issues in their area, our NAVCA members are working hard to support the VCS in this area.

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At NAVCA, we are working with our members on the Social Prescribing agenda and supporting the coordination of the Health and Wellbeing Alliance. We are facilitating and advocating for the embedding of local infrastructure in Integrated Care Systems and at place level, through supporting members and influencing policies and guidance.

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There is much work to do to create fairer health outcomes for people. By keeping the focus on local but influencing nationally, we can be part of the change that needs to happen, ensuring that people and communities are at the centre of policy-making and investment for better health and wellbeing.

This diagram explains the main determinants of health really clearly, and encourages us to think more broadly about health, beyond health care services.