The educational charity, the Sutton Trust, has published a report on the impact of "cognitive gaps in the early years," as shown especially in language skills. Using the Millennium Cohort Survey, researchers found that children from the poorest families are nearly a year behind their peers from middle income families at age 5. The report identifies good parenting and a supportive home environment as key factors and suggests, amongst other ideas, that outreach projects from Sure Start are the way ahead.
More evaluation of the New Deal for Communities programme (see Fair's Fair 19 January for earlier reports), this time looking at health outcomes. There's a focus on projects in the four NDC case study areas, Fulham, Hackney, Salford and Sandwell, as well as considering more generally how NDC partnerships work and looking at how these kinds of initiatives can be sustained.
The Audit Commission has cast its beady eye over local implementation of government policy for children aged 0-5 during the past ten years. Giving children a healthy start looks at the impact of government funding on the health of under fives, considering how well local agencies manage the finances on offer and how far they are providing value for money. The report also discusses means to improve service delivery to vulnerable and hard-to-reach populations, such as lone and teenage parents and BME groups. Initiatives like Sure Start and the Healthy Child Programme are duly namechecked. However, criticism, when it comes, is reserved for lack of strategic commitment, with under fives' health "not always reflected in strategic plans, and ... rarely given priority in local area agreements (LAAs)." Along with the report, there's also a video showcasing some local initiatives.
February's issue of the European Journal of Public Health has a focus on environmental inequalities and health, ahead of the WHO Ministerial Conference on Environment and Health in Parma on 10-12 March. Articles cover ambient air quality, waste management and housing amongst other topics.
Poorer people in the UK have shorter lives and are more likely to live with disability is the headline from the Marmot review report, Fair Society, Healthy Lives. The report puts a number on the gap: "the average difference in disabilityfree life expectancy is 17 years." Although the past 10 years have seen a significant rise in spending on healthcare and in general prosperity levels, these inequalities, set out clearly in the Black report of 1980, persist and have deepened. While the diagnosis may be clear and largely undisputed, the cure is another matter. At a time when the healthcare system, along with broader social welfare policy, is under some financial pressure, this may not be a message governments are prepared to embrace. A guarded welcome from the King's Fund notes that "cash invested in initiatives to tackle health inequalities doesn’t produce instant returns," encouraging the government to stick with the programme. Professor David Hunter, writing in the BMJ, observes "eerie echoes " with the timing of the Black report, which, although commissioned by a Labour government, was issued into the hands of a Conservative one, remarking also that "there are few votes in health inequalities."
How unequal is British society? The National Equality Panel, in its report on economic inequality, breaks the bad news (or tells us what we know already) about the distribution of wealth in the UK. In spite of all efforts to change the situation "the large inequality growth between the late 1970s and early 1990s has not been reversed. " While some of the widest gaps (such as those in educational qualifications amongst some ethnic groups) have narrowed, there remain "deep-seated and systematic differences in economic outcomes between social groups" in all the dimensions the Panel considered. The report looks at educational achievement, employment status and income as well as wealth per se.
Tributes to Sir Donald Acheson have been pouring in: the Guardian, the Times and the Telegraph have all carried obituaries recently. Acheson, who died on 10 January 2010, was Chief Medical Officer between 1983 and 1991. Although the end of his term of office was somewhat clouded by the BSE crisis, he is remembered more appreciatively for his ability to persuade the Thatcher government “to adopt a liberal approach” in tackling AIDS, focusing on education, rather than compulsory AIDS testing (says the Guardian). He is also widely credited with raising the profile of public health. However, it is for his 1998 report on health inequalities that he will be best remembered. Tasked by the incoming Labour government with examining the causes of a widening gap between the health of rich and poor, the report has shaped public health policy for a decade. Looking ahead, it is expected that the Marmot Review, which picks up where Acheson left off, will be published in February.
