A decade after his groundbreaking 2010 Fair Society, Healthy Lives review, Sir Michael Marmot and colleagues assess the UK’s health landscape in Health Equity in England. The authors reveal that for the first time in over a century, life expectancy improvements have stalled nation-wide, and declined among the poorest 10% of women. Notably, health disparities have widened, with stark regional inequalities: the health gap between Northeast deprived areas and wealthy London suburbs has grown dramatically. They also show that people are spending a greater portion of their lives in poor health. Crucially, the review links these negative trends to the social determinants of health-including austerity cuts, poverty, housing, education, and employment-underscoring that more than 80% of the slowdown in health gains stems from these broader societal factors, not healthcare services or seasonal illness.
To address these issues, Marmot et al. advocate for renewing the 2010 policy agenda through proportionate universalism-universal interventions scaled to need-and setting cross-sector priorities: giving every child the best start; enabling all to maximize capability; ensuring healthy standard of living; creating fair work; building healthy, sustainable places; and strengthening illness prevention. The report calls for a dedicated national strategy, led at Cabinet level, to coordinate action across government departments and local authorities. It emphasizes the importance of long-term investment and political commitment to improve social conditions and reduce health inequalities, warning that continued inaction risks reversing public health progress and harming social solidarity.