Annual Public Health Report 2020

• Did you know your physical and mental health is affected by your income, housing, job, education, your access to healthcare and its quality, and the environment surrounding you? To understand how this relates to Suffolk, you can read and hear from some of Suffolk's residents.

• Not only who you are…but also where you live, the services you can access, and the choices (or lack of them) that you have, will directly and indirectly affect how long and how healthy a life you may have. And not everyone has the same opportunity to live as long, or as well, as others.

• Health inequalities are the unfair and avoidable differences in health - found across our community, and between different groups. They exist in all areas, including unequal experiences of health services, education, work and housing opportunities. Health can also be affected by the different ethnic, cultural, religious, gender or social groups with which you identify.

• These are some common features of health inequalities that most people agree on:
  • Health inequalities are unjust, unfair and avoidable
  • They do not occur by chance. They go against the principles of social justice, and they are largely out of an individual’s control
  • These socially determined circumstances disadvantage people and limit their chances to live longer healthier lives
• It is only recently that this was demonstrated with clear evidence. In 2010, Professor Sir Michael Marmot published a groundbreaking report that made big headlines. Fair Society, Healthy Lives showed that the worse off someone is socially and economically, the more likely they are to experience poor health and live a shorter life, compared to those who come from a better-off background.
• Over the last 10 years, there’s been a growing understanding that lots of factors contribute to someone’s good health, and being ill is often the result of lots of factors overlapping, but yet things haven’t improved. The Marmot Review: 10 Years On showed that life expectancy had stopped improving in the UK, and for some it had got worse.
• The COVID-19 global pandemic has increased awareness of health inequalities because the virus has unequally affected those from specific ethnic and social groups in our communities. There is also concern that increasing unemployment, job uncertainty, and interruptions to education and certain physical and mental health services will increase pre-existing health inequalities, and potentially create new ones.
• We could do more as a system and with our community to reduce health inequalities. This digital report this year now starts the conversation and plan for action on how we can work together with you in the community to reduce health inequalities in Suffolk

There are many factors that influence health. We may know about the ones based on the genes you inherit, and those determined by the choices we make: whether we smoke, drink or take regular exercise. But there are also the ‘wider determinants’ of health or sometimes, social determinants, of health. These are important and indirectly affect our health and wellbeing. Examples of wider determinants are where someone lives, what qualifications they have and what job they do, but also the quality of health services someone can access.

Health behaviours, socio-economic factors, clinical care and the built environment all interact to influence our health. However, this doesn't include some of the things like our genes. Many of us do not sit in one category – we are unlikely to experience one inequality, many of us will experience the effects of several at the same time. Improving wider determinants is complicated because often it’s out of one person's control, and needs government and societal change.

COVID-19 and the resulting national lockdown that began on 23 March 2020 affected the lives of everyone in Britain. Some people had support and found it easier to cope with, while others did not. Many in our community have faced isolation, hunger, serious physical and mental ill-health and the devastating loss of loved ones.

The COVID-19 experience has shown that outcomes have been worse for certain groups in our communities, for example those from ethnic minority backgrounds, people and with underlying health conditions or doing certain jobs. Public Health England's review report on disparities in August 2020 describes this evidence. It is also becoming increasingly apparent that any long-term impact of the pandemic on the economy will increase poverty and potentially widen existing health inequalities.

Almost all of us experience health inequalities or the effects of them at some point during our lives. It is important that we work together to address health inequalities as evidence shows that not one individual, group or organisation can tackle health inequalities on their own. Take a look at our reasons for why this digital report should identify with all of us: 

• You may identify with one of the groups in this report and feel the findings reflect your experiences.

• You may not identify with one of the groups but we invite you to read this report and understand the effects on others in our community.

• The evidence shows that ‘if health stops improving society stops improving’

• The COVID-19 experience has affected the health of some groups more than others and increased pre-existing inequalities. It has also put others at risk of experiencing them – for example those affected financially.

In this year’s digital report we are focusing on health inequalities. Not only are they an important issue in their own right, but COVID-19 has made this even more critical.

The combination of factors that contribute to health inequalities is complex. The many factors that influence the wider determinants of health mean that not one organisation or group acting alone can reduce health inequalities. This is why all the relevant organisations are working together to identify and address the inequalities and reduce them.

So the key health and wellbeing organisations in Suffolk have agreed to take action, supported by this digital report – which has been developed collaboratively. This will build on our work of reducing health inequalities which has been a key part of the Health and Wellbeing Board strategy since 2012.

We know our approach must be joined up, consistent, with an emphasis on working with the communities which can most benefit from targeted interventions and support over the long-term. Take a look at our good project examples to see some of your work that has been done in Suffolk.

But there’s much more to be done. In this digital report we also introduce practical approaches and make recommendations that will make a difference. We need your involvement to start these conversations and make this happen!

This digital report makes some recommendations about a longer term plan for reducing inequalities. Let us know what you think about them, and whether you can help.

We have all experienced lockdown but how well do we understand what it was like for others in our community? How well do we understand how those changes will continue to impact on local people’s lives in the upcoming months and years? The key factor to remember is that the COVID-19 pandemic has highlighted health inequalities like never before. If ever there is time for action, it is now. Have a look on our pages to find out what Suffolk has told us, what they are doing to help tackle health inequalities and what more could be done to work together and take action.

This digital report sets out recommendations about a long-term plan for reducing inequalities. Let us know what you think about them, and how you can help.

You can get in touch using social media using hashtag such as #YourHealthySuffolk
On our Commitment to Change page, you can let us know your thoughts on our report and recommendations to address health inequalities by filling out a two question form.

Here is our easy-read introduction to the health inequalities report (PDF document) explaining what health inequalities are and why they are the feature of this year's report.

We also made an easy-read glossary (PDF).

We have followed our language guide for this digital report. This aims to give a consistent guide for use of certain terminology and language we commonly use within Suffolk's Public Health and Communities team. The guide was built from input given by the whole Public Health and Communities team, and reviewed by colleagues at HealthWatch Suffolk.

Some of the words in the data, facts and figures sections on our Types of Health Inequalities page may be new to you and you may not have come across before.

• Here is a glossary we have produced for this digital report.
• Here is a easy-read glossary we have produced for this digital report (PDF Document)