DEPRIVED communities have been ‘ignored’ during a decade of austerity that’s led to widening health inequalities, a damning new report has said.

Sir Michael Marmot’s landmark review comes 10 years after he first published data on the growing gap between the rich and poor in England.

Ten years on, in a decade that has seen brutal and disproportionate funding cuts to local authorities across the UK, a new report has been published that explores what has changed since the 2010 Marmot Review.

The report, which was commissioned by the Health Foundation, reveals that life expectancy has stalled for the first time in more than 100 years.

In a foreword to the report, Prof Marmot, who is the director of the UCL Institute of Health Equity, says England is “faltering”.

For part of the decade 2010-2020, life expectancy fell in the most deprived communities outside London for women and in some regions for men.

And for men and women everywhere, the time spent in poor health is increasing, something Prof Marmot says is “shocking”.

“Austerity has taken its toll in all the domains set out in the Marmot Review,” Prof Marmot says.

“From rising child poverty and the closure of children’s centres, to declines in education funding, an increase in precarious work and zero hours contracts, to a housing affordability crisis and a rise in homelessness, to people with insufficient money to lead a healthy life and resorting to foodbanks in large numbers, to ignored communities with poor conditions and little reason for hope.”

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Prof Marmot says these outcomes, on the whole, are even worse for minority ethnic population groups and people with disabilities.

While he says the review cannot say with certainty which adverse trends might be responsible for the worsening health picture in England, some, such as the increase in child poverty, will mostly show their effects in the long-term.

“We can say, though, that austerity has adversely affected the social determinants that impact on health in the short, medium and long term,” says Prof Marmot.

“Austerity will cast a long shadow over the lives of the children born and growing up under its effects.”

In England, the report says, the proportion of children in poverty is projected to continue to increase under present government policies causing children’s life chances to “diminish further”.

This is underpinned by projections by the Institute for Fiscal Studies, which predicts relative child poverty after housing costs will increase to 36.6 percent in 2021 in the UK.

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The report notes that child poverty is not an inevitability, but “largely the result of political and policy choices in areas including social protection, taxation rates, housing and income and minimum wage policies”.

Since 2010, the report says, levels of deprivation and exclusion have “intensified” in many places across England.

Government spending has decreased most in the most deprived places and cuts in services outside health and social care have hit more deprived communities the hardest.

St Helens is one of the most deprived areas in the country, in terms of relative health deprivation and disability, with St Helens Council seeing devastating funding cuts over the last decade.

By 2020, the council says it will have lost £90 million from its budget, cuts that have seen statutory services cut to the bone and some non-statutory services lost altogether.

Poorer areas, where council tax receipts and business rates are already low, require a greater proportion of their funding from central government grants to local authorities.

But it is in these areas, with the greatest need, where grants have been cut the most over the last decade.

The Marmot Review says that since 2009-10 net expenditure per person in the most deprived local authorities has fallen by 31 percent, compared with a 16 percent decrease in the least deprived areas.

“Throughout England there are communities and places that have been labelled ‘left behind’, where multiple forms of deprivation intersect and where deprivation has persisted for many years with little prospect of alleviation,” the report says.

“We call them ignored communities.

“Over the last 10 years, these ignored communities and areas have seen vital physical and community assets lost, resources and funding reduced, community and voluntary sector services decimated and public services cut, all of which have damaged health and widened inequalities.

“These lost assets and services compound the multiple economic and social deprivations, including high rates of persistent poverty and low income, high levels of debt, poor health and poor housing that are already faced by many residents.”

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In conclusion, the ’10 years on’ report shows that, in England, health is getting worse for people living in more deprived districts and says action must be taken not only to improve living conditions for the worst off, but also for those who are relatively disadvantaged.

“Funding should be allocated in a proportionate way – those areas that have lost the most and are more deprived must receive renewed investment first and at higher levels,” the report says.

“We repeat: we neither desire nor can envisage a society without social and economic inequalities.

“But the public thinks that inequalities have gone too far, and evidence from across the world suggests that the level of health inequality we see in England, is unnecessary.

“We welcome action from local and regional governments to tackle social determinants of health.

“More action of the type we have described here will be necessary. It is not, though, a matter of action by either central government or local government: we need both and we need leadership.

“If we leave this for another 10 years, we risk losing a generation.”

Here are some key findings from the Marmot Review 10 years on:

Life expectancy

  • Increases in life expectancy have slowed since 2010 with the slowdown greatest in more deprived areas of the country.
  • Inequalities in life expectancy have increased since 2010, especially for women.
  • Female life expectancy declined in the most deprived 10 percent of neighbourhoods between 2010-12 and 2016-18 and there were only negligible increases in male life expectancy in these areas.
  • There are growing regional inequalities in life expectancy, with life expectancy is lower in the North and higher in the South.
  • Healthy life expectancy has declined for women since 2010 and the percentage of life spent in ill health has increased for men and women.

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Children and young people

  • Rates of child poverty have increased since 2010 and are now back to their pre-2010 levels, with more than four million children affected.
  • More than 70 percent of children in workless families are in poverty, affecting 1.3 million children, up from around 60 percent in 2010.
  • More deprived areas have lost more funding for children and youth services than less deprived areas, even as need has increased, while violent youth crime and particularly knife crimes have increased greatly since 2010.
  • Since 2014 areas suffering the largest cuts to spending on young people have seen bigger increases in knife crime than other areas.
  • Since 2010 the number of exclusions from school have significantly increased in both primary and secondary schools.
  • Pupil numbers have risen while funding has decreased by eight percent per pupil, with particularly steep declines in funding for sixth form (post-16) and further education.

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  • The costs of housing, including social housing, have increased, pushing many people into poverty, and ill health.
  • Renters have been proportionately the hardest hit, both because incomes have declined and the cost of renting has increased.
  • The number of non-decent homes has decreased, even in the private rental sector, but this sector still has high levels of cold, damp and poor conditions, and insecure tenures, which harm health.
  • Tax and benefit reforms have widened income and wealth inequalities.
  • Homelessness and rough sleeping has risen significantly, by 165 percent between 2010 and 2017.
  • In 2018 there were 69 percent more children in homeless families living in temporary accommodation than in 2010.


  • There has been an increase in poor quality work, including part-time,
  • insecure employment.
  • The number of people on zero hours contracts has increased significantly
  • since 2010.
  • Real pay is still below 2010 levels and there has been an increase in the proportion of people in poverty living in a working household.
  • Automation is leading to job losses, particularly for low-paid, part-time workers and the north of England will be particularly affected.

St Helens Star: Sue Forster, director of public health at St Helens Council Sue Forster, director of public health at St Helens Council

What is St Helens Council doing to address the health inequalities outlined in the Marmot Review?

Sue Forster, St Helens Council’s director of public health, said the authority is taking “great strides” to improve the health and wellbeing of residents.

Despite this, like many areas in the North, life expectancy has stalled in the borough and healthy life expectancy reduced.

In St Helens, healthy life expectancy for women has decreased from 62 in 2011-13 to 59.3 in 2016-18.

For men, healthy life expectancy has reduced from 62.2 in 2011-13 to 59.2 in 2016-18.

Ms Forster said she welcomes the findings in the Marmot Review and said the council and its partners are working hard to address some of the underlying issues.

“St Helens has been working to improve wellbeing and our work to improve people’s health through social prescribing is addressing health and social issues,” she said.

“This programme is being rolled out in all general practices in 2020.

“Our workplace health is driving improvements throughout the council with the introduction of mental health first aiders and work is continuing to support the wider business community with help from the council’s business liaison officer.

“St Helens is also contributing to the consultation on the Liverpool City Region Fair Employment Charter.

“A healthy weight strategy will go before cabinet this week, which will focus on child obesity and the strategy takes a whole systems approach to the issue and not a focus on lifestyle alone.

“A new working group is set up to review our air quality action plan which will support a healthy environment and also support the council pledge on climate change.

“While St Helens is continuing to address health and health inequalities, the Marmot Review and the recommendations will be used to prioritise local action.”

St Helens Star: St Helens Council leader David Baines St Helens Council leader David Baines

What is the leader of St Helens Council saying in response to the Marmot Review’s findings?

Cllr David Baines said the Marmot Review is a “stark and comprehensive account” of the impact of austerity on people and communities.

The Labour leader said it is the responsibility of all those in public office to do “everything possible to address its conclusions.”

But Cllr Baines warned that, without sufficient support from central government, people in places like St Helens will “continue to suffer”.

“Ten years of government cuts to essential services in boroughs like ours have had a devastating direct effect on many people, and on the services that are meant to be there to support them,” Cllr Baines said.

“Among other things, the report highlights the impact on health of poverty, of poor housing, and of a lack of employment opportunities.

“In addition to the good work highlighted by Sue Forster, which we’ve achieved despite massive government cuts, that’s why our Labour council is committed to providing employment opportunities and attracting new employers to the borough, to working with Torus and others to build new, quality, affordable housing in all our communities, and to working with partners from the public, private and third sectors to address the causes of poverty at the root, and not just the symptoms.

“For example, tomorrow (Thursday) Cllr Andy Bowden – our Labour spokesperson for Fighting Poverty – will be chairing a poverty summit at the town hall with attendees including the local Citizens Advice Bureau, the Department for Work and Pensions, foodbank, churches, Torus and others.

“Poverty and health are complex issues and only by working together can we get the best results, but the fact is that without government support areas like ours will find it an uphill struggle, and people will continue to suffer.

“The Marmot Review is essential reading, and it’s the responsibility of all those in public office to do everything possible to address its conclusions.”

Click here to read the Marmot Review 10 Yeas on in full.