We need a national plan to tackle the health inequity that is killing people | Life expectancy

How could I criticize Aditya Chakrabortty’s account of failing to prioritize the health of the nation when he cites me as an inspiration (It’s a life and death story for the UK – so why has it been swept under the rug?, March 6). However, it is important to emphasize that the government is well aware of the gross health inequities that are ravaging our country and limiting lives and economic prosperity, but is choosing not to prioritize them. Last month’s ministerial response to the House of Lords report on aging contains this shocking statistic: a girl born in Barnsley can expect on average 53 years of good health, while a girl born in Wokingham can expect 71 years of good health, an extra 18 years.

Across the country, deprivation accelerates aging, which for many means premature and unnecessary exit from the labor market and a premature need for social protection. But the main focus of health policy is the overt commitment to reducing NHS waiting times, a goal which has very little impact on health inequalities. Instead, a radical program is needed to prevent the largely social and commercial determinants of poor health, such as poverty, poor diet, lack of exercise and air pollution.

In the absence of a national health improvement plan (after twenty years in Sweden), regional mayors Andy Burnham and Oliver Coppard launched their own ten-year initiatives to tackle health inequalities. If the government decides to change course, these plans could easily be expanded. But this requires a bold political choice giving priority to health as well as disease.
Alan Walker
Emeritus Professor of Social Policy and Social Gerontology, University of Sheffield

Aditya Chakrabortty is right to be outraged by the report on declining healthy life expectancy. However, this is just one indicator that paints a picture of health inequities, something that has remained largely unchanged for a century or more. Health inequality is an issue rarely addressed comprehensively in British politics, let alone used intelligently to guide policy.

The 1980 Black Report and the 1998 Acheson Report specifically highlighted the failure to address these broader determinants of health, but their recommendations were never consistently followed. The Conservative administration reversed progress made after 2010, for example decimating the public health sector, but the issue was as crucial in 2010 as it is today. Sir Michael Marmot’s commitment to keeping this topic at the forefront is second to none. He said it in 2008 and it is still true today: “social injustice kills on a large scale”.
Neil Blackshaw
Alnwick, Northumberland

Aditya Chakrabortty castigates Conservatives and Liberal Democrats for economic austerity that has led to our declining healthy life expectancy. He does not mention Labour’s Gordon Brown or his chancellor Alistair Darling. In their manifesto they warn of no fewer than seven “tough choices” if they win the 2010 election. These include £15 billion in “efficiency” savings, £11 billion in “overhead” cuts, £5 billion in spending cuts, £20 billion from asset sales and, can you believe it, 1p on national insurance contributions.

Unfortunately, all of our parties share responsibility for the groupthink that has imposed misguided neoliberal policies, and all must learn from this. With increased but fairer taxation, we can already afford to treat the less fortunate with compassion and repair our public domain. We don’t need to wait for growth, we can do it now.
Peter Wrigley
Birstall, West Yorkshire