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Determinants of Health Update July 2021

Welcome to this month’s policy update from HLA:THINK

Through these regular updates we will share with you some of the key developments in different areas of health and care policy, all through publicly available resources.

If you are interested in the work of HLA:Think and would like to get involved, feel free to contact us on

Health equity and Covid-19

Covid-19 has highlighted long-standing health inequities and inspired calls to “build back fairer”. The Institute of Health Equity (IHE), established and led by Professor Sir Michael Marmot, published a report on the equity impacts of the pandemic in December. This month saw the publication of the report Build Back Fairer in Greater Manchester, which is the result of a 2-year collaboration between the city and IHE to inform and support action on health inequalities in Greater Manchester. The full report is accompanied by a visual briefing note and a high-level summary. We also include a report on the experience of older people living in areas of multiple deprivation within Manchester.

These efforts are closely related to the government’s levelling up agenda, which promises to ‘increase prosperity, widen opportunity and ensure that no region is left behind.’ The briefing by the Health Foundation highlights that the current policy proposals that comprise levelling up are partial and fragmented, and have so far not linked health and welfare outcomes with the allocation of resources and assessing progress. The briefing’s authors suggest a more comprehensive approach that will balance financial and physical, human, social, and natural capital.

The provision of social care is another area of concern when considering the equity impacts of the pandemic. A recent survey by Age UK, a charity, highlights that Covid-19 and the associated policy response substantially increased the need for social care. A report by the Health Foundation from July 2020 found that care home residents and staff were at increased risk of death during the pandemic. The organisation published a follow-up report in May, which highlighted that long-standing structural issues like system fragmentation and workforce issues exacerbated the situation and made an effective, coordinated policy response less likely.

Housing and communities

High streets and local communities have long been acknowledged as a determinant of health, including in a recent PHE report. In this month’s bulletin, we include a number of pieces, including a report by the Centre for Policy Studies outlining how to improve this in the post-covid era, as well as the first literature review on the impact of private renting on health and wellbeing. Housing was also a big theme in the Chief Medical Officer’s annual report which looked at the health of coastal towns, and made a number of recommendations to healthcare training and to funding


Climate change

Parts of Canada, the US Pacific Northwest and the Arctic Circle are suffering sweltering heatwaves that have already caused hundreds of sudden deaths. This was predicted by the World Metereological Organization. According to the US-based National Oceanic and Atmospheric Administration, it is because of a “heat dome” lingering over the northern hemisphere and trapping concentrations of hot air in place. In parts of Western Europe and China, unprecedented amounts of rainfall led to catastrophic floods that killed upwards of 200 people and left hundreds more displaced.

In the Lancet this month, scientists claim that the increasingly common extreme weather phenomena are evidence of the ever-worsening climate crisis. 6 years ago, countries committed to limit global warming to “well below 2°C” as part of the landmark Paris Agreement. Despite this, the five hottest years on record have occurred since 2015. Around 30% of the world’s population are currently exposed to climatic conditions exceeding the deadly threshold of temperature for at least 20 days a year, and this proportion is only expected to rise. The continued rise in temperatures is expected to have a detrimental impact on human health directly and indirectly through reduction in crop yields and micronutrients.

Produced by Rok Hrzic, Soham Bandyopadhyay and Arrash Yassaee



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