INSIGHT 2020 – Week 4: Exploring Health Inequalities 


COVID-19 has shone a light on health inequalities; it has “laid bare our longstanding social, economic and political inequalities…” (BMJ, 2020) and this is against a backdrop of declining life expectancy in our poorest communities, well before COVID-19.

The Marmot review 10 years on found that regional and socioeconomic differences in health are large and growing. Michael Marmot describes this as ‘shocking’ and that we should work towards creating the conditions for everyone to be able to lead lives they have reason to value. 

During this week’s theme we shared a special selection of events which looked at health inequalities through very different lenses. We considered where health inequalities exist, what we have learned during the COVID-19 pandemic and what we are doing to address them that we need to amplify? 

Homelessness and Covid-19: using research to learn in a crisis

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During this session we heard about the experiences of research teams from homelessness charity Groundswell and the Strategy Unit. Both had been asked to gather evidence to provide decision makers – in NHS England and NHS Improvement (NHSE/I), and elsewhere – with the insights they needed to learn from the health and care response to homelessness during COVID-19. 

Speakers: Olivia Butterworth (Head of Public Participation for NHS England and NHS Improvement), Jenny McAteer (Directs Groundswell’s national #HealthNow project), Jo Brown (Research Manager at Groundswell) and Fraser Battye (The Strategy Unit) 

The Trauma of COVID-19 - a creative response to the effects of the pandemic and lockdown on children and young people

An open exploration of the range of trauma that has been experienced by children and young people as a result of the pandemic, the possible implications and how we, as a society and suite of public services, need to respond and be creative in so doing. 

Speakers: Dr. Ingrid Wolfe (Chair, Consultant in paediatrics and public health; Director, Institute for Women’s and Children’s Health, Kings Health Partners) Nigel Osborne (Composer, researcher and international aid worker, Sally Rowe (Executive Director of Children’s Services, Walsall Council), Swaran Singh (Professor of Social and Community Psychiatry, University of Warwick) and Peter Spilsbury (Director, The Strategy Unit) 

Health inequalities and ethnicity

In this session we focussed on the recent findings of poorer health outcomes from COVID-19 for ethnic minority populations in England and beyond. We shared high-level findings from a qualitative study undertaken by the Strategy Unit, exploring the experience of Black and Ethnic Minority individuals who were symptomatic for COVID-19 in the first wave of the pandemic. We discussed what were meaningful questions to ask, and answer, for decision-makers working to improve the health of their population sub-groups. 

Speakers: Abeda Mulla and Mahmoda Begum (The Strategy Unit) 

Panel discussion: exploring health inequalities

During this event we summed up what we had heard during the week about inequalities, followed by a panel discussion. The discussion focussed on ‘so it’s 50 years since the Tudor-Hart “inverse care law” was set out, and in many of those years the NHS and its constituents have produced worthy plans talking about the level of inequalities. And yet they remain rife.’ As we emerge from COVID and as we seek to establish integrated systems our panel considered: What is going to change? What will a health and care system, truly galvanised by addressing inequalities, look and feel like? And what will we do less of in order to do more for disadvantaged people? 

Speakers: Professor Sir Muir Gray, Lucy Heath (Academy Director, Black Country and West Birmingham CCGs), Dr. Farzana Hussain (GP Principal, Clinical director for Newham Central 1 PCN, Co-Chair of NHS Confederation National CD PCN Network), Paul Maubach (CEO, Black Country and West Birmingham CCGs), Professor Chris Bentley (Previously head of the Health Inequalities, National Support Team) and Fraser Battye (The Strategy Unit) 

Panel discussion: shaping future analytical priorities

What are the big analytical questions on the horizon for the DSC? This week we looked at some of the significant analysis being conducted on behalf of the Midlands, as well as nationally, and thought about the implications of this work for decision-makers and analysts in health and care. 

This panel discussion brings together some of the expert speakers from the week. They were asked to think about what was next and invited discussion from the audience to help shape the analytical priorities of the future. 

Speakers: Andi Orlowski (Director, The Health Economics Unit), Gareth Wrench, Steven Wyatt and Paul Mason (The Strategy Unit) 

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