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Your money AND your life? Closing the health gap in Sheffield
Sheffield Equality Group
21 October 2010
Health Inequalities in Sheffield
Jeremy Wight
Director of Public Health
Health inequalities in Sheffield
• Inequalities present and past
• Causes of health inequality
• What can and are we doing about it?
• Last thoughts
Your money AND your life? Closing the health gap in Sheffield
Your money AND your life? Closing the health gap in Sheffield
Your money AND your life? Closing the health gap in Sheffield
Your money AND your life? Closing the health gap in Sheffield
Health inequalities in 1892
Fairer Sheffield, Healthy LivesDistrict All age mortality / 1000 Infant mortality
Sheffield West 24.15 198.0
Sheffield North 27.65 270.3
Sheffield South 22.24 222.2
Sheffield Park 22.33 201.2
Brightside 20.20 206.1
Attercliffe 21.17 266.6
Nether Hallam 08.90 198.9
Upper Hallam 14.60 100.0
Eccleshall 17.80 158.1
All Sheffield 20.75 205.3
Health inequalities in 1987
What do we mean by health
inequality?
• Analysis by:
– Geography
– Income
– Class
– ‘Community of interest’
• Analysis of:
– Mortality / life expectancy
– Other measures of health and wellbeing
What are the causes of health
inequality?
• Causes of death
• Causes of disease
• Causes of the causes
• Residential sorting?
Causes of death (m)
Male
Attributable LE gap
(yrs)
Proportion of
gap
Coronary Heart Disease 0.5 19.8%
Lung Cancer 0.2 9.3%
Chronic Obstructive Airways Disease 0.2 8.9%
Other Cardiovascular Diseases 0.2 6.2%
Other Accidents 0.1 5.0%
Chronic Cirrhosis of the Liver 0.1 5.0%
Suicide & Undetermined Injury 0.1 4.5%
Pneumonia 0.1 3.9%
Other Digestive Diseases 0.1 3.9%
Stroke 0.1 3.6%
Deaths Under 1 Year of Age * 0.1 5.3%
All other 0.6 24.6%
Causes of death (f)
Female Attributable LE gap (yrs)
Proportion
of gap
Lung Cancer 0.3 14.8%
Chronic Obstructive Airways Disease 0.2 14.2%
Coronary Heart Disease 0.2 14.1%
Stroke 0.1 8.4%
Other Respiratory Diseases 0.1 5.8%
Other Cardiovascular Diseases 0.1 5.7%
Pneumonia 0.1 5.0%
Chronic Cirrhosis of the Liver 0.1 4.5%
Ill-Defined Conditions 0.1 4.4%
Diseases of the Nervous System 0.1 3.1%
Deaths Under 1 Year of Age * 0.0 0.8%
All other 0.3 19.2%
Causes of disease
• Smoking
• Physical inactivity
• Poor diet
• Alcohol
• Drugs
Causes of the causes
• Cheap and illicit tobacco (smuggling)
• Absolute and relative poverty
• Unemployment and underemployment
• Poor housing
• Low educational achievement
• Low aspiration
Inequality in wellbeing
• Nic Marks – New Economics Foundation
Diminishing marginal returns
of well-being to income
Life satisfaction and Household income in the UK
5.00
5.50
6.00
6.50
7.00
7.50
8.00
£0
£20,000
£40,000
£60,000
£80,000
£100,000
£120,000
£140,000
Household total net income
LifeSatisfaction(0-10)
Diminishing marginal returns
of well-being to income
Life Satisfaction and Income Quintiles
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
Low Income Low-Medium
Income
Medium
Income
High-Medium
Income
High Income
LifeSatisfaction(0-10)
Average Social Connection
What are we doing about it?
• What has worked in the past – CIRC
• Fairer Sheffield, Healthy Lives
<75 Circulatory Mortality Rates
%decrease in rate relative to 1997-1999
-60%
-50%
-40%
-30%
-20%
-10%
0%
2004-
2006
2003-
2005
2002-
2004
2001-
2003
2000-
2002
1999-
2001
1998-
2000
Most Deprived ED Quintile Sheffield
Public Health Analysis Team, Sheffield PCT
Male Life Expectancy Gap
Male Life Expectancy -
Gap between Most Deprived Neighbourhood Quintile and Sheffield
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
LifeExpectancyGap(Years)
Actual gap Exponential projection Linear projection 2010 Target Gap
Actual gap 3.4 3.4 3.1 2.9 2.8 3.0 3.2 3.2
Exponential projection 3.0 2.9 2.9 2.9 2.8 2.8 2.7 2.7 2.7 2.6
Linear projection 2.9 2.9 2.9 2.8 2.8 2.7 2.7 2.7 2.6 2.6
2010 Target Gap 3.4 3.4 3.4 3.3 3.3 3.3 3.2 3.2 3.2 3.1 3.1 3.1
1997-
2001
1998-
2002
1999-
2003
2000-
2004
2001-
2005
2002-
2006
2003-
2007
2004-
2008
2005-
2009
2006-
2010
2007-
2011
2008-
2012
2009-
2013
2010-
2014
2011-
2015
2012-
2016
2013-
2017
2014-
2018
Source: Public Health Analysis Team, Sheffield PCT ( 5 year rates)
Female Life Expectancy Gap
Female Life Expectancy
Gap between Most Deprived Neighbourhood Quintile and Sheffield
-0.5
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
LifeExpectancyGap(Years)
Actual gap Exponential projection Linear projection Target Gap
Actual gap 2.9 2.4 2.3 2.2 2.0 1.8 1.8 1.8
Exponential projection 1.5 1.3 1.2 1.0 0.9 0.7 0.6 0.4 0.3 0.1
Linear projection 1.5 1.3 1.1 1.0 0.8 0.7 0.5 0.3 0.1 0.0
Target Gap 2.9 2.9 2.9 2.8 2.8 2.8 2.8 2.7 2.7 2.7 2.6 2.6
1997-
2001
1998-
2002
1999-
2003
2000-
2004
2001-
2005
2002-
2006
2003-
2007
2004-
2008
2005-
2009
2006-
2010
2007-
2011
2008-
2012
2009-
2013
2010-
2014
2011-
2015
2012-
2016
2013-
2017
2014-
2018
Source: Public Health Analysis Team, Sheffield PCT( 5 year rates)
Fairer Sheffield, Healthy Lives
Health Inequalities Action Plan
2010-2013
Fairer Sheffield, Healthy Lives
Fairer Sheffield Healthy Lives
• Based on Marmot report
• 6 areas for action:
– Give every child the best start in life
– Enable all to maximise capabilities and have control
over their lives
– Create fair employment and good work for all
– Ensure a healthy standard of living for all
– Create and develop healthy and sustainable places
and communities
– Strengthen the role and impact of ill health prevention
What would a really radical
approach look like?
• Shuffling and re-distributing the population
• Equalising incomes
• De-normalising tobacco smoking in all parts of
society
• De-criminalising currently illegal drugs
• Random allocation of school places across the
City
Conclusions
• Health inequalities are deeply ingrained in the
unequal nature of society
• As public health leadership moves from the NHS
to local authorities, it is vital that links with
General Practice are not lost
• Efforts to reduce inequalities must focus on
improving the health of disadvantaged
communities
• There have been huge improvements in the
health of disadvantaged communities, even if
health inequalities have not reduced as much as
we would wish.
Closing the health gap
in Sheffield
Danny Dorling
7pm Thursday 21st October 2010
Domino Hall, Sheffield Cathedral
Health inequalities have exercised people in Sheffield for many years.
This extract below is from ‘Sheffield Targets’ thanks to Geoff Green for
sending me a copy of the 1987 pamphlet, in which it said:
Here is the map then. No average is now below age 65, but
the gap is now much larger in terms of life expectancy
30/01/15 © The University of Sheffield
Average life expectancy varies by 20 years at the extreme (for
women). For men the gap has more than doubled to 16 years.
But these are all figures from below the economic crash and
before the spending cuts and their effects on inequality
National Government policy had been here – more reviews and
yet more reviews but income inequalities rising slowly (6.1:1 to
7.2:1 between quintile groups 1997-2008 in the UK)
Then came the spending review
October 20th
2010 – we were
told how savings would be
made:
One of the first
announcements was that new
tenants of council and other
social housing will now have
to pay at least 80 percent of
market prices in rent. In one
stroke millions of low paid
families are to be excluded
from living in hundreds of
towns, cities and villages
where they no longer earn
enough to “deserve” to be.
Housing benefit will not be
paid for people under the age
of 35 who live alone—this
previously applied only to
those under 25.
There would be a 10 percent
cut in council tax benefit for
those who can not afford to
live in certain areas.
Are the few remaining people
living on modest incomes
near affluent suburbs or in
economically successful
towns and villages to be
cleansed away?
It could be the greatest threat
The best-off fifth of society will
lose just 1 percent of their
entitlements to public services
and spending, the lowest losses
of any group.
A million people currently on
employment and support
allowance due to ill health will
each loose £2,000 a year if they
cannot find a job.
With the state pension age rising
rapidly to 66 years. Only those
with private provision can now
retire at the normal age. Public
sector pensioners will have £1.8
billion removed from them by
2014-15. Pension credits will be
frozen for three years.
No family on benefits is to receive
more than the income of an
average family in work, no matter
what the circumstances of their
children. If you are poor—or are
made poor when you lose your
job or have a pay cut forced on
you—and have three or more
children, you may need to leave
your town for a new life in a
cheaper area, away from where
the remaining well paid work is.
People with worse health will
have to move to poorer areas.
The health service is being cut
Provision for the NHS did not
include the extra costs of the
1946 baby boomers retiring,
or the cost of new
privatisations being
introduced there (which were
not even in the Tory
manifesto – but are now
taking place).
Provision for education would
not maintain current rates of
spending per child once the
new privatised “free” school
costs are added in. University
places will be slashed. This
will change who lives where
and hence health inequalities.
As school budgets will also be
cut, in practise parents may
try even harder to live away
from more average areas – if
they can – raising health
inequalities higher again.
The educational maintenance
allowance for less well-off
children will be phased out,
another significant cut to
children’s finances which,
when combined with all the
chancellor’s other measures,
means that child poverty will
rise—despite what he
suggested in this speech
Redistribution to better-off
More affluent savers who lost
money they invested in
Equitable Life and the
Presbyterian Mutual Society
will soon receive £1.7 billion
from tax payers—mostly from
tax payers poorer than them.
Thus money is being
redistributed towards the
affluent.
There will be more property
for the affluent to buy with
these windfalls in affluent
areas, in villages and in
market towns, as the poor
vacate their homes for
cheaper places to live –
increasing inequality.
Local government will be
allowed to borrow more in
richer areas, against
expected business rates,
instead of Westminster
borrowing, so that the places
where business makes a lot
of money can be spruced up.
Local government in poorer
areas cannot make such
newly permitted borrowing.
Although there are a few
token schemes outside the
South East, most capital
spending is now concentrated
there as a result of the cuts.
This is a common response
• On 21 October, Teresa
Perchard, director of policy
at the Citizens Advise
Bureau, warned that
housing benefit changes
would “create a group of
nomads…maybe not
where the jobs are.”
• On the same BBC radio
programme, Alan
Johnston said that
Osborne’s speech was
“unfair, unwise and
untruthful in some of the
statistics” and that the
chancellor was “asking
children to make a bigger
contribution than the
• The former Conservative
chancellor, and current
secretary of state for
justice, Ken Clark (69),
had warned of a double-
dip recession if cuts were
savage.
• Many younger people will
now go abroad to find work
or a university place. Many
of them will never return.
Poorer families will
struggle the most, but
fewer will be visible
through the windows of
ministerial cars
Think back to 1985 & WHO1
• In 1985 Margaret Thatcher signed
the WHO target to reduce
inequality by 25% by 2000.
• It increase by much more than
25%. She had not thought it would.
• The gap was measured between
areas for all age groups and for
infants by social class
• She believed in “trickle down”, in a
private sector lead recovery that
would bring prosperity to all, with
the worst-off benefitting the most
as the well-off already lived the
longest. She thought she was fair
• More people died young as a
result.
Conclusion – keep asking
Why are 16 or 20 countries better?
The latest UN report lists those
European countries currently having a
higher life expectancy than the UK as:
Iceland (almost 82 years),
Switzerland, Italy, France (81 years),
Sweden, Spain, Norway, Austria (to
almost 80 years), the Netherlands,
Germany, Ireland, Malta, Cyprus,
Finland, Belgium and Luxembourg.
People also live for longer than in
Britain in Australia, Canada and New
Zealand (and especially Japan), but
not in the United States (where
comparable life expectancy is only
79.1 years)
People do live slightly shorter lives
now in Greece, Portugal (more
economically unequal than the UK),
Denmark (where smoking is still very
common) and in Slovenia (78.2
years). All these figures are from
Table H of the most recent UNDP
human development report (2009)
and purport to be for around the year
2007.
Life expectancy is up in the UK, but
Increased economic inequality in the
UK would be expected to move our
rank position below one of these four
countries next, to slip from 20th
place
to 21st
or 22nd
out of 25.
Of the richest 25 nations in the world
the UK is the 4th
most unequal by income
inequality (90:10 ratio UNDP figures).
Is premature death a price worth
paying in the eyes of some policy
makers? – just “inevitable”….
An email – received today
“Oh Danny you are far far to nice and reasonable a person to really understand just how
callous and murderous this lot really are. They are the aristocracy and they really do
not 'give a ****' about the poor or even the middle class.”
“The best way to explain the effects of the changes to housing benefit is to quote the
Tory ministers own words i.e. which ministers say will force an exodus from London
and other areas with high property prices ? "it's the Highland clearances", one said”
“Their plan is a 'Highland Clearance' of London, the South East, Bath,
York, Bristol, Edinburgh, etc. This is not an accidental change it is a
deliberate planned strategy.”
… “about 50,000 households will be affected, with hundreds of thousands more hit by
the cap on housing benefit (which ministers say will force an exodus from London
and other areas with high property prices ? "it's the Highland clearances", one [Daily
Telegraph quoted but not named Tory minster] said).‘”
Cheers!
Source of ministerial quote: Ben Brogan, 2010, “Conservative party conference 2010:
Let battle commence”, Daily Telegraph, 6th
October:
http://www.telegraph.co.uk/comment/columnists/benedict-
brogan/8047179/Conservative-party-conference-2010-Let-battle-commence.html
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Your money AND your life? Closing the health gap in Sheffield

  • 3. Sheffield Equality Group 21 October 2010 Health Inequalities in Sheffield Jeremy Wight Director of Public Health
  • 4. Health inequalities in Sheffield • Inequalities present and past • Causes of health inequality • What can and are we doing about it? • Last thoughts
  • 9. Health inequalities in 1892 Fairer Sheffield, Healthy LivesDistrict All age mortality / 1000 Infant mortality Sheffield West 24.15 198.0 Sheffield North 27.65 270.3 Sheffield South 22.24 222.2 Sheffield Park 22.33 201.2 Brightside 20.20 206.1 Attercliffe 21.17 266.6 Nether Hallam 08.90 198.9 Upper Hallam 14.60 100.0 Eccleshall 17.80 158.1 All Sheffield 20.75 205.3
  • 11. What do we mean by health inequality? • Analysis by: – Geography – Income – Class – ‘Community of interest’ • Analysis of: – Mortality / life expectancy – Other measures of health and wellbeing
  • 12. What are the causes of health inequality? • Causes of death • Causes of disease • Causes of the causes • Residential sorting?
  • 13. Causes of death (m) Male Attributable LE gap (yrs) Proportion of gap Coronary Heart Disease 0.5 19.8% Lung Cancer 0.2 9.3% Chronic Obstructive Airways Disease 0.2 8.9% Other Cardiovascular Diseases 0.2 6.2% Other Accidents 0.1 5.0% Chronic Cirrhosis of the Liver 0.1 5.0% Suicide & Undetermined Injury 0.1 4.5% Pneumonia 0.1 3.9% Other Digestive Diseases 0.1 3.9% Stroke 0.1 3.6% Deaths Under 1 Year of Age * 0.1 5.3% All other 0.6 24.6%
  • 14. Causes of death (f) Female Attributable LE gap (yrs) Proportion of gap Lung Cancer 0.3 14.8% Chronic Obstructive Airways Disease 0.2 14.2% Coronary Heart Disease 0.2 14.1% Stroke 0.1 8.4% Other Respiratory Diseases 0.1 5.8% Other Cardiovascular Diseases 0.1 5.7% Pneumonia 0.1 5.0% Chronic Cirrhosis of the Liver 0.1 4.5% Ill-Defined Conditions 0.1 4.4% Diseases of the Nervous System 0.1 3.1% Deaths Under 1 Year of Age * 0.0 0.8% All other 0.3 19.2%
  • 15. Causes of disease • Smoking • Physical inactivity • Poor diet • Alcohol • Drugs
  • 16. Causes of the causes • Cheap and illicit tobacco (smuggling) • Absolute and relative poverty • Unemployment and underemployment • Poor housing • Low educational achievement • Low aspiration
  • 17. Inequality in wellbeing • Nic Marks – New Economics Foundation
  • 18. Diminishing marginal returns of well-being to income Life satisfaction and Household income in the UK 5.00 5.50 6.00 6.50 7.00 7.50 8.00 £0 £20,000 £40,000 £60,000 £80,000 £100,000 £120,000 £140,000 Household total net income LifeSatisfaction(0-10)
  • 19. Diminishing marginal returns of well-being to income Life Satisfaction and Income Quintiles 4.0 4.5 5.0 5.5 6.0 6.5 7.0 7.5 8.0 8.5 Low Income Low-Medium Income Medium Income High-Medium Income High Income LifeSatisfaction(0-10) Average Social Connection
  • 20. What are we doing about it? • What has worked in the past – CIRC • Fairer Sheffield, Healthy Lives
  • 21. <75 Circulatory Mortality Rates %decrease in rate relative to 1997-1999 -60% -50% -40% -30% -20% -10% 0% 2004- 2006 2003- 2005 2002- 2004 2001- 2003 2000- 2002 1999- 2001 1998- 2000 Most Deprived ED Quintile Sheffield Public Health Analysis Team, Sheffield PCT
  • 22. Male Life Expectancy Gap Male Life Expectancy - Gap between Most Deprived Neighbourhood Quintile and Sheffield 0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 LifeExpectancyGap(Years) Actual gap Exponential projection Linear projection 2010 Target Gap Actual gap 3.4 3.4 3.1 2.9 2.8 3.0 3.2 3.2 Exponential projection 3.0 2.9 2.9 2.9 2.8 2.8 2.7 2.7 2.7 2.6 Linear projection 2.9 2.9 2.9 2.8 2.8 2.7 2.7 2.7 2.6 2.6 2010 Target Gap 3.4 3.4 3.4 3.3 3.3 3.3 3.2 3.2 3.2 3.1 3.1 3.1 1997- 2001 1998- 2002 1999- 2003 2000- 2004 2001- 2005 2002- 2006 2003- 2007 2004- 2008 2005- 2009 2006- 2010 2007- 2011 2008- 2012 2009- 2013 2010- 2014 2011- 2015 2012- 2016 2013- 2017 2014- 2018 Source: Public Health Analysis Team, Sheffield PCT ( 5 year rates)
  • 23. Female Life Expectancy Gap Female Life Expectancy Gap between Most Deprived Neighbourhood Quintile and Sheffield -0.5 0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 LifeExpectancyGap(Years) Actual gap Exponential projection Linear projection Target Gap Actual gap 2.9 2.4 2.3 2.2 2.0 1.8 1.8 1.8 Exponential projection 1.5 1.3 1.2 1.0 0.9 0.7 0.6 0.4 0.3 0.1 Linear projection 1.5 1.3 1.1 1.0 0.8 0.7 0.5 0.3 0.1 0.0 Target Gap 2.9 2.9 2.9 2.8 2.8 2.8 2.8 2.7 2.7 2.7 2.6 2.6 1997- 2001 1998- 2002 1999- 2003 2000- 2004 2001- 2005 2002- 2006 2003- 2007 2004- 2008 2005- 2009 2006- 2010 2007- 2011 2008- 2012 2009- 2013 2010- 2014 2011- 2015 2012- 2016 2013- 2017 2014- 2018 Source: Public Health Analysis Team, Sheffield PCT( 5 year rates)
  • 24. Fairer Sheffield, Healthy Lives Health Inequalities Action Plan 2010-2013 Fairer Sheffield, Healthy Lives
  • 25. Fairer Sheffield Healthy Lives • Based on Marmot report • 6 areas for action: – Give every child the best start in life – Enable all to maximise capabilities and have control over their lives – Create fair employment and good work for all – Ensure a healthy standard of living for all – Create and develop healthy and sustainable places and communities – Strengthen the role and impact of ill health prevention
  • 26. What would a really radical approach look like? • Shuffling and re-distributing the population • Equalising incomes • De-normalising tobacco smoking in all parts of society • De-criminalising currently illegal drugs • Random allocation of school places across the City
  • 27. Conclusions • Health inequalities are deeply ingrained in the unequal nature of society • As public health leadership moves from the NHS to local authorities, it is vital that links with General Practice are not lost • Efforts to reduce inequalities must focus on improving the health of disadvantaged communities • There have been huge improvements in the health of disadvantaged communities, even if health inequalities have not reduced as much as we would wish.
  • 28. Closing the health gap in Sheffield Danny Dorling 7pm Thursday 21st October 2010 Domino Hall, Sheffield Cathedral
  • 29. Health inequalities have exercised people in Sheffield for many years. This extract below is from ‘Sheffield Targets’ thanks to Geoff Green for sending me a copy of the 1987 pamphlet, in which it said:
  • 30. Here is the map then. No average is now below age 65, but the gap is now much larger in terms of life expectancy
  • 31. 30/01/15 © The University of Sheffield Average life expectancy varies by 20 years at the extreme (for women). For men the gap has more than doubled to 16 years. But these are all figures from below the economic crash and before the spending cuts and their effects on inequality
  • 32. National Government policy had been here – more reviews and yet more reviews but income inequalities rising slowly (6.1:1 to 7.2:1 between quintile groups 1997-2008 in the UK)
  • 33. Then came the spending review October 20th 2010 – we were told how savings would be made: One of the first announcements was that new tenants of council and other social housing will now have to pay at least 80 percent of market prices in rent. In one stroke millions of low paid families are to be excluded from living in hundreds of towns, cities and villages where they no longer earn enough to “deserve” to be. Housing benefit will not be paid for people under the age of 35 who live alone—this previously applied only to those under 25. There would be a 10 percent cut in council tax benefit for those who can not afford to live in certain areas. Are the few remaining people living on modest incomes near affluent suburbs or in economically successful towns and villages to be cleansed away?
  • 34. It could be the greatest threat The best-off fifth of society will lose just 1 percent of their entitlements to public services and spending, the lowest losses of any group. A million people currently on employment and support allowance due to ill health will each loose £2,000 a year if they cannot find a job. With the state pension age rising rapidly to 66 years. Only those with private provision can now retire at the normal age. Public sector pensioners will have £1.8 billion removed from them by 2014-15. Pension credits will be frozen for three years. No family on benefits is to receive more than the income of an average family in work, no matter what the circumstances of their children. If you are poor—or are made poor when you lose your job or have a pay cut forced on you—and have three or more children, you may need to leave your town for a new life in a cheaper area, away from where the remaining well paid work is. People with worse health will have to move to poorer areas.
  • 35. The health service is being cut Provision for the NHS did not include the extra costs of the 1946 baby boomers retiring, or the cost of new privatisations being introduced there (which were not even in the Tory manifesto – but are now taking place). Provision for education would not maintain current rates of spending per child once the new privatised “free” school costs are added in. University places will be slashed. This will change who lives where and hence health inequalities. As school budgets will also be cut, in practise parents may try even harder to live away from more average areas – if they can – raising health inequalities higher again. The educational maintenance allowance for less well-off children will be phased out, another significant cut to children’s finances which, when combined with all the chancellor’s other measures, means that child poverty will rise—despite what he suggested in this speech
  • 36. Redistribution to better-off More affluent savers who lost money they invested in Equitable Life and the Presbyterian Mutual Society will soon receive £1.7 billion from tax payers—mostly from tax payers poorer than them. Thus money is being redistributed towards the affluent. There will be more property for the affluent to buy with these windfalls in affluent areas, in villages and in market towns, as the poor vacate their homes for cheaper places to live – increasing inequality. Local government will be allowed to borrow more in richer areas, against expected business rates, instead of Westminster borrowing, so that the places where business makes a lot of money can be spruced up. Local government in poorer areas cannot make such newly permitted borrowing. Although there are a few token schemes outside the South East, most capital spending is now concentrated there as a result of the cuts.
  • 37. This is a common response • On 21 October, Teresa Perchard, director of policy at the Citizens Advise Bureau, warned that housing benefit changes would “create a group of nomads…maybe not where the jobs are.” • On the same BBC radio programme, Alan Johnston said that Osborne’s speech was “unfair, unwise and untruthful in some of the statistics” and that the chancellor was “asking children to make a bigger contribution than the • The former Conservative chancellor, and current secretary of state for justice, Ken Clark (69), had warned of a double- dip recession if cuts were savage. • Many younger people will now go abroad to find work or a university place. Many of them will never return. Poorer families will struggle the most, but fewer will be visible through the windows of ministerial cars
  • 38. Think back to 1985 & WHO1 • In 1985 Margaret Thatcher signed the WHO target to reduce inequality by 25% by 2000. • It increase by much more than 25%. She had not thought it would. • The gap was measured between areas for all age groups and for infants by social class • She believed in “trickle down”, in a private sector lead recovery that would bring prosperity to all, with the worst-off benefitting the most as the well-off already lived the longest. She thought she was fair • More people died young as a result.
  • 39. Conclusion – keep asking Why are 16 or 20 countries better? The latest UN report lists those European countries currently having a higher life expectancy than the UK as: Iceland (almost 82 years), Switzerland, Italy, France (81 years), Sweden, Spain, Norway, Austria (to almost 80 years), the Netherlands, Germany, Ireland, Malta, Cyprus, Finland, Belgium and Luxembourg. People also live for longer than in Britain in Australia, Canada and New Zealand (and especially Japan), but not in the United States (where comparable life expectancy is only 79.1 years) People do live slightly shorter lives now in Greece, Portugal (more economically unequal than the UK), Denmark (where smoking is still very common) and in Slovenia (78.2 years). All these figures are from Table H of the most recent UNDP human development report (2009) and purport to be for around the year 2007. Life expectancy is up in the UK, but Increased economic inequality in the UK would be expected to move our rank position below one of these four countries next, to slip from 20th place to 21st or 22nd out of 25. Of the richest 25 nations in the world the UK is the 4th most unequal by income inequality (90:10 ratio UNDP figures). Is premature death a price worth paying in the eyes of some policy makers? – just “inevitable”….
  • 40. An email – received today “Oh Danny you are far far to nice and reasonable a person to really understand just how callous and murderous this lot really are. They are the aristocracy and they really do not 'give a ****' about the poor or even the middle class.” “The best way to explain the effects of the changes to housing benefit is to quote the Tory ministers own words i.e. which ministers say will force an exodus from London and other areas with high property prices ? "it's the Highland clearances", one said” “Their plan is a 'Highland Clearance' of London, the South East, Bath, York, Bristol, Edinburgh, etc. This is not an accidental change it is a deliberate planned strategy.” … “about 50,000 households will be affected, with hundreds of thousands more hit by the cap on housing benefit (which ministers say will force an exodus from London and other areas with high property prices ? "it's the Highland clearances", one [Daily Telegraph quoted but not named Tory minster] said).‘” Cheers! Source of ministerial quote: Ben Brogan, 2010, “Conservative party conference 2010: Let battle commence”, Daily Telegraph, 6th October: http://www.telegraph.co.uk/comment/columnists/benedict- brogan/8047179/Conservative-party-conference-2010-Let-battle-commence.html See this and many other related presentations in full multimedia on http://sasi.group.shef.ac.uk/presentations/

Notas del editor

  1. 14 year gap in life expectancy has both individual and neighbourhood components