The government risks “condemning” the next generation of children to “less flourishing” lives than their parents if it fails to tackle existing health inequalities exacerbated by the coronavirus pandemic, a health expert has warned.
Professor Sir Michael Marmot urged ministers to do “whatever it takes” to put improving health at the “heart” of all government policy, as he published a damning new report highlighting the devastating impact the virus and containment measures have had on people in England.
The report, Build Back Fairer: The Covid-19 Marmot Review, found that the pandemic had damaged everyone’s prospects of improved long-term health, but particularly children who are at risk of shorter lives post-pandemic.
With Tory-led austerity having caused a decade of worsening health inequalities, it was “unfortunately entirely predictable” that the government’s methods of controlling the virus would “make poor people poorer” and “maybe even make [rich people] richer”, said Prof Marmot, director of the University College London (UCL) Institute of Health Equity.
His report found that the pandemic had adversely affected young people’s social and emotional development, widened the education gap, reduced family incomes and increased poverty and unemployment.
But in addition to Covid-19, underlying health, deprivation, occupation and ethnicity all accelerated regional inequalities, particularly in the North West and North East, the report found.
It said these were “undermined by pre-pandemic regressive cuts” and “made worse by differing pandemic containment measures”, warning it would be a “tragic mistake” if the country went back to the “status quo” that existed before the pandemic.
The report highlighted that England’s excess death rate is the highest in Europe – with Prof Marmot adding that the “social gradient” of the link between mortality and deprivation seen before the pandemic was “remarkably similar” to the trajectory during the outbreak.
“The inequalities in Covid-19 and the inequalities in health are not different phenomena,” he said. “They're almost the same phenomenon.”
Prof Marmot also said coronavirus deaths among ethnic minority communities were “shockingly high”.
He emphasised the need to tackle the “structural racism” that leads to systemic disadvantages such as poorer living conditions and exposure to the virus at work.
And the report warned that an increase in alcohol consumption, smoking, obesity inequalities and declines in mental health during the pandemic was leading to a “new health crisis”.
Prof Marmot cited contributing factors as “poor governance”, social and economic inequalities, reductions in spending on public services and England being an “unhealthy” nation going into the pandemic.
A previous report produced by Prof Marmot in February found that “flatlining” life expectancy and worsening health inequalities over the past 10 years had led to a “lost” decade in England.
Prof Marmot said policymakers were previously “not putting health and wellbeing as a priority” and should have seen the growing “crisis” in health inequalities.
Outlining a raft of recommendations for government, the epidemiologist warned that unless it takes action, it risks England becoming “increasingly an unhealthy country with large inequalities” with the danger that it could “fall behind other European countries in a way that is unnecessary”.
“I think if you don't follow the kind of recommendations we make, we are condemning the next generation to a less flourishing life than their parents had,” he said.
He highlighted countries in Asia, such as Korea, as examples of nations that had controlled the pandemic “well” with less economic and social impact.
Short-term recommendations in the report include catch-up tuition for students in deprived areas, removing the “two child” benefit cap, extending furlough support, funding additional training for young people, increasing local government Covid-19 grants, and raising public health funding from 0.15 per cent to 0.5 per cent of GDP.
In the longer-term, the report calls for efforts to reduce child poverty, make increased Universal Credit payments permanent, focus on reducing inequalities in early years development, cut pollution levels in deprived areas and build affordable, carbon-neutral homes.
“We can't afford not to do this,” Prof Marmot said, arguing that government debt is “no excuse”.
“We've got some incorrect notion about the necessity of austerity,” he added.
Dr Jennifer Dixon, chief executive of the Health Foundation, which commissioned the report, said: “Mitigating the damage caused by the pandemic to education, employment and income must be at the heart of the Government's plans for recovery and levelling up.
“For young people, this means practical help to find employment and training to access better quality jobs. As we rebuild, these measures are vital to ensure that the generation of young people who have lived through the pandemic don't continue to feel its impact on their health throughout the rest of their lives.”
Professor Dame Parveen Kumar, chairwoman of the British Medical Association board of science, said: “With England's Covid-19 excess death rate being the highest in Europe, our inability to withstand the pandemic as well as other comparable rich counties is an important lesson in the value of good public health.”
She urged action on addressing the link between deprivation and structural racism, and added: “It is absolutely unacceptable that in a country of such means there is such a strong divide between the richest and poorest in society.
“This report should serve as an important call to action for the Government to invest in the health of this nation in the long term as, in these challenging uncertain times, closing the gap has never been more important.”
Additional reporting by PA
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