Three Ways in Which Public Health England (PHE) Attempts to Minimize Inequalities in Health

Inequalities in health have become a significant public health problem in many countries globally. Health inequalities refer to the measurable disparities in health outcomes and experiences between different groups within a given population based on their geographical area, socioeconomic status, gender, age, disability, or ethnic group (Scambler, 2012). On the other hand, public health is the art and science of prolonging life, preventing diseases, and promoting human health through organized efforts and informed choices of the society, individuals, and other relevant entities, (Newton et al., 2015). In this regard, Public Health England (PHE) is in charge of safeguarding and enhancing the nation's health, as well as, addressing inequalities. Some of the fundamental causes of health inequalities include unequal dissemination of power, income, and wealth, just to mention a few (Marmot & Allen, 2014). The variances in these social determinants impact negatively on people thus limiting their ability to live longer and healthier lives (Scambler, 2012). Similarly, the inequalities are transferred from one generation to another in many instances, thus creating a continuous cycle of public health problems which in turn influences the overall productivity of the country (Martinson, 2012).It is in the light of this context that this paper identifies and discusses three ways in which public health England attempts to minimize health inequalities in the country.

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The health of individuals in England has improved remarkably over the last few decades. Research has pointed out that the life expectancy of men in 1841 was 40.2 years while that of women was 42.2 years (Newton et al., 2015). Similar studies conducted in 2000 revealed that the life expectancy of men had improved to 75.6 years and that of women to 80.3 years (Newton et al., 2015). Moreover, the infant mortality rates have decreased significantly throughout the 20th century in response to proper nutrition and improved living conditions, among other factors (Marmot et al., 2016). However, there is still a huge gap between the rich and poor in terms of their overall health outcomes, life expectancy, and access to healthcare despite the notable improvement in public health in the country (Pickett & Wilkinson, 2015). As a result, more effective steps and policies need to be implemented to address these inequalities in public health.

Causes of Health Inequalities in England

Health inequality in England is caused by various elements including socio-economic aspects, lack of access to healthcare, and lifestyle factors, just to mention. Some of the socio-economic aspects attributed to health inequalities are unemployment, poor income, and inadequate education (Beckfield, Olafsdottir & Bakhtiari, 2013). In this regard, the high rates of unemployment and poor paying jobs in the country have plunged many families into poverty thus making it difficult for them to afford basic needs and proper medical care (Bleich, Jarlenski, Bell & LaVeist, 2012). Similarly, most deaths and health problems are associated with lack of knowledge and inadequate information on how to manage or prevent certain diseases (Marmot et al., 2016). Uneven access to healthcare is also another aspect that is related to high mortality rates, particularly, in the underserved regions due to lack of timely treatment. Moreover, lifestyle factors such as drinking, smoking, and poor eating habits are among the leading causes of health problems and inequalities in England.

The Black Report

The government has taken various steps to identify and tackle health inequalities in England. For instance, in 1980 the UK department of health and security established a report famously known as the (black report) outlining in great detail the extent in which ill health, life expectancy, and mortality rates were unequally distributed among the population (Bartley, 2016). The report also highlighted the major causes of health inequalities and provided a number of recommendations on how to address the issues in question( Marmot & Bell, 2012). The suggestions were, however, disowned by the secretary of state for social services during that era and very few people got a chance to read the report. On the other hand, it sensitized the government on health inequality issues and some of its recommendations were adopted in the Acheson report 1998.

The Acheson Report

The Acheson report played an integral role in compelling the government to tackle health inequality issues in various regions of the country. The report was published in 1998 with an objective to review current information regarding health inequalities (Fish & Karban, 2014). It also helped in identifying priority areas for future policy development intended to minimize disparities in health. Additionally, it took a general account of the government's overall financial strategies and identified areas that needed improvement. In this regard, some of the recommendations provided in the Acheson report became part of a wider government drive for new policies addressing poverty and social justice (Mackenbach, 2012). The developments were facilitated by the creation of new mechanisms such as the introduction of the PSA target framework which was meant to promote the government's ambitions and top priorities for delivery (Carey & Crammond, 2015). In this case, the Acheson report provided a cornerstone for all subsequent work on health inequalities. That is to say, it underpinned the national health inequality strategies, informed the Treasury-led cross-cutting review, and resonates in the latest document, Health Inequalities; Progress and Next Steps (2008), which sets out the future targets for confronting health disparities.

Steps Taken by Public Health England to Minimize Health Inequalities

The Sure Start Program

The sure start program is an initiative sponsored by the government to support children, mothers, and families living in disadvantaged areas across England. It was introduced in 1998 as a multi-departmental project for early intervention of children under the age of four years (Eyal et al., 2013). The program was intended to bring together a range of services including family support, childcare, education, as well as, support for special needs, just to mention a few (WHO, 2017). The initiative began with 60 Sure Start trailblazer districts which were composed of voluntary bodies, health services, and the local authorities (Eyal et al., 2013). In 2000 the government committed PS948 million to double the number of Sure Start Local Programmes (SSLP) to 500 with an intention to cover majority of the poorest children under the age of four. The facilities were later converted into Sure Start Children Centers( SCC) in 2003 and represented the mainstreaming of Sure Start as a universal service (WHO, 2017). In this regard, the SCC made it possible for the government to reach out to families and children who had not been previously covered by the SSP.

The implementation of the Sure Start Centers ( SSC) has considerably improved the health of women and children across the country. In this regard, the SCCs provide a wide range of services for parents, children, and families with an aim of ensuring their emotional, social, and economic well-being (Ingleby, 2012). The centers support pregnant mothers and offer them ante-natal and post-natal care, as well as informed advice on how to bring up healthy children. The programme receives full funding from the government amounting to almost PS4 million per year (Barr, Bambra & Whitehead, 2014). It has been able to cater for the health needs of many children and families living in underserved areas and thus contributing to the government's efforts of minimizing health differences in the country. However, studies have pointed out that there has been a continuous shut down of many Sure Start centers, particularly, in areas where they are needed the most (Eyal et al., 2013). For example, a poll conducted recently revealed that the centers had decreased from 3,632 in 2010 to 2,677 in 2015 (WHO, 2017). In this case, the reduction in the number of the Sure Start centers in underserved regions has negatively affected the health of many residents thus contributing to the existing health inequalities in England. As a result, policymakers and the government should design and implement efficient policies to address this problem

Ensuring a Healthy Living Standard For Everyone

Public health England has taken various steps to promote healthy living standards for everyone in the society. First, it has been on the front row in sensitizing the population about the importance of adopting healthy lifestyles through public education and training programmes. Studies have shown that most of the deaths and chronic diseases in the nation are caused by unhealthy behaviors such as poor nutrition, excessive alcohol consumption, and inactivity, among other contributing factors (Scambler, 2012). As a result, empowering individuals to make healthy choices is vital in minimizing health inequalities. Secondly, the organization has been working closely with the government to advocate and execute policies to reduce the social gradient in the standard of living through proper taxation and other fiscal policies (Eyal et al., 2013). This initiative is meant to reduce the gap between the rich and poor and minimize the disparities in health, especially, those caused by social-economic factors such as unequal distribution of wealth. Thirdly, PHE has partnered with various organizations and the government to resolve the rampant unemployment problem in the country by improving access to jobs for persons living in underprivileged areas(Scambler, 2012). In this regard, creating employment opportunities for everyone will enable them to cater for the needs of their families thus improving their living standards. Lastly, efforts have been made towards improving healthcare delivery by promoting quality and timely treatment and increasing the number of care providers in underprivileged regions.

Resource Allocation/Funding

The government has set aside resources to fund projects and policies aimed at minimizing and mitigating the effects of health disparities in the country. The department of health is in charge of allocating resources to the National Health Service (NHS) which ensures the proper planning, budgeting, and utilization of funds meant to address the health needs of different groups in the society. The funding formula ensures that there is an adequate redistribution of funds, especially, to the neediest group in the population (Scambler, 2012). The allocations are made to the PCTs based on the relative needs of their populations which are evaluated through a weighted capitation formula which is continuously overseen by the Independent Advisory Committee on Resource Allocation (ACRA). In this regard, the ACRA makes recommendations to government representatives and policymakers on possible changes to the formula prior to each round of revenue allocation (Martinson, 2012). Research has, however, shown that not all areas are currently receiving the amount of money they should receive based on their needs. As a result, there is still a huge gap between the rich and poor in terms of their health outcomes, life expectancy, and mortality rates. It is in this respect that the government should identify effective ways of dealing with these issues and thus minimize the disparities in health between the rich and poor.

Impact of the Health Inequality Initiatives

The three health inequality initiatives mentioned above including the Sure Start Program, facilitati...