INSIGHT 2021: Reducing health inequalities – the practical & ethical challenges

Reducing health inequalities – the practical & ethical challenges

This session debated the ethical challenges around addressing health inequalities. We heard from our expert panel as Insight 2021 looks at the ethical and practical challenges of reducing health inequalities.

• Professor Sir Michael Marmot: Professor of Epidemiology at University College London, Director of the UCL Institute of Health Equity, and Past President of the World Medical Association
• Dr. Julian Huppert: Director of the Intellectual Forum, Jesus College, Cambridge and NHS NED
• Professor Swaran P Singh: Director, Centre for Mental Health and Wellbeing Research, University of Warwick and ex equality and human rights commissioner
• Kelly Beaver: Managing Director of Ipsos MORI’s Public Affairs Division

Tackling health inequalities has gone up the health and care agenda recently. The pandemic made stark what many already knew: England is a divided and unequal country.

This drew immediate responses. Most immediately, there were signs of solidarity and simple acts of kindness. Many of us came together as neighbours and local communities in a renewed way. The NHS has also given renewed emphasis to health inequalities in its guidance and strategies. And, more broadly, the government has signalled its intention to ‘level up’ post-Brexit and post-pandemic.

• But will this translate into action?
• Will these factors play through into improved outcomes?
• Has the pandemic created a break point, opening new possibilities for addressing health inequalities – or will we slide back into previous lack of progress?

And durable, sometimes controversial, ethical issues also remain.

• If we are to tackle health inequalities, are we prepared to do this even if at the expense of overall improvements ( seeing greater equity as trumping maximising improvement of the average for example)?
• Are we to consider positive discrimination when it comes to access to services?
• How do we rank the effort to find those in need who aren’t presenting with treating those who stand before us?
• Within a fixed resource, who has the legitimacy to determine that some population groups should get more and some less?
• Is there public support to do this? Does it matter if there isn’t?