1. Eastern and Coastal Kent West Kent Health Inequalities in Kent – What can we learn from Marmot Meradin Peachey Director of Public Health Mark Lemon Head of Policy

2. Kent Department of Public Health Eastern and Coastal Kent West Kent The Life Course of Health

3. Kent Department of Public Health Eastern and Coastal Kent West Kent The Social Gradient of Health Inequalities

4. Kent Department of Public Health Eastern and Coastal Kent West Kent A Kent and Medway example Circulatory disease aged under 75

5. Kent Department of Public Health Eastern and Coastal Kent West Kent

6. Kent Department of Public Health Eastern and Coastal Kent West Kent The Conceptual Framework. Reduce health inequalities and improve health and well-being for all. Create an enabling society that maximises individual and community potential. Ensure social justice, health and sustainability are at heart of policies. Give every child the best start in life. Create fair employment and good work for all. Enable all children, young people and adults to maximise their capabilities and have control over their lives. Ensure healthy standard of living for all. Create and develop healthy and sustainable places and communities. Strengthen the role and impact of ill health prevention. Equality and health equity in all policies. Effective evidence-based delivery systems. Policy objectives Policy mechanisms

7. Kent Department of Public Health Eastern and Coastal Kent West Kent Key themes Reducing health inequalities is a matter of fairness and social justice Action is needed to tackle the social gradient in health – Proportionate universalism Action on health inequalities requires action across all the social determinants of health Reducing health inequalities is vital for the economy – cost of inaction Beyond economic growth to well-being

8. Kent Department of Public Health Eastern and Coastal Kent West Kent Cost of Inaction in lean times In England, dying prematurely each year as a result of health inequalities between 1.3 and 2.5 million extra years of life lost – the human cost- 200000 deaths of 30+. Economic benefits in reducing losses from illness associated with health inequalities. Each year in England these account for: –productivity losses of £31-33B –reduced tax revenue and higher welfare payments of £20- 32B –increased treatment costs well in excess of £5B.

9. Kent Department of Public Health Eastern and Coastal Kent West Kent Making it happen – A framework for delivery Increased disability free life expectancy and reduction in inequalities across the gradient. Empowering people : securing community solutions. Intergovernmental action with dedicated leadership and executive team. National Policies need effective local deliver focussed on health equity in all policies. New model of civic and public sector leadership grounded in democracy and whole system thinking Local Strategic Partnerships of Councils, NHS, 3rd Sector and Private Sector creating the conditions where individuals and communities take control. Comprehensive, systematic, scaled up, co-produced action focussed on the social determinants of health.

10. Kent Department of Public Health Eastern and Coastal Kent West Kent Partnerships with individuals and communities Critical success factor in addressing health inequalities through empowerment – creating the conditions in which people can take control –Bespoke individual responses –Population focused approaches Asset based partnership – half full not half empty –Sharing power –Community led and long term –Shift in values and attitudes –Leadership and knowledge transfer. Shared aspirations in improving health and wellbeing –Perceptions of local schools, health and social care service, housing type,employment,safety and social cohesion. Balancing long-term gains and short-term pressures.

11. Kent Department of Public Health Eastern and Coastal Kent West Kent Conclusion The Marmot report emphasises that solutions to health inequalities are social not medical The recommendations and key principles underpin and develop the ‘Big Society’ To improve health inequalities communities’ and individual’s resilience needs to be developed The relationship between the citizen and the state must be recast We should continue to use our proven approaches of Social Marketing and co-production to effect change

12. Kent Department of Public Health Eastern and Coastal Kent West Kent Thank you for listening