Despite overall improvements in disability-free life expectancy from 1991 to 2011, significant geographical health inequalities, and as a result  wealth inequalities, widened across the UK.

Unfortunately, over a decade later, the conversation hasn’t moved on much further. Health Equity in England: The Marmot Review 10 Years On, the 2020 follow-up to Sir Michael Marmot’s landmark study, found that the gap in healthy life expectancy between wealthy and deprived  areas has continued to grow.

As part of its levelling up agenda, the UK Government set itself an ambitious target to add five additional healthy years to the average UK lifespan by 2035. It has also set a target of narrowing the gap in Healthy Life Expectancy between the ‘healthiest’ and ‘unhealthiest’ local  authority areas by 2030.

Yet it’s unclear how the Government intends to achieve these two goals, especially given the recent decision to abandon the promised white paper on health disparities. In addition, the fallout from the COVID-19 pandemic and the current cost-of-living crisis are likely to widen existing inequalities.

This policy briefing has been produced following report of the Health of Older People in Places (HOPE) project which was published in October 2022.

The briefing recommends that the UK Government:

• Increase spending on preventative health programmes (which are delivered by local authorities) to at least 6% of the national health budget. Funds should be directed towards the strengthening local prevention programmes
• Earmark part of the £4.8 billion levelling up infrastructure fund for projects that will create jobs suitable for older workers in the ‘unhealthiest’ local authority areas, especially in those where a high proportion of employment is in manual work.
• Confirm that there will be another census in 2031 and monitor and publish annual data on health in a place for people aged over 50. Both should measure health (including self-rated health) and labour market participation.

The Health of Older People in Places (HOPE) project was led by researchers at UCL in collaboration with ILC-UK and Leeds University, and funded by the Health Foundation under the Social and Economic Value of Place programme. We gratefully acknowledge the permission of the Office for National Statistics (ONS) to use the Longitudinal Study.