Helen Haggart, Senior Policy AdviserFebruary 2014

The British Academy’s role in strengthening policy making

The British Academy

The British Academy is the UK’s independent national academy representing the humanities and social sciences.

For over a century it has supported and celebrated the best in UK and international research and helped connect the expertise of those working in these disciplines with the wider public.

Public Policy at the British Academy

How we engage with policy makers

• Regular meetings with key stakeholders• Working in partnership with others• Hosting events and conferences on relevant topics• Publishing reports on a particular policy issue• Consultation responses and briefings• Briefing them on our reports• Publishing opinion pieces and articles in the media

“If you could do one thing...”

A collection of nine proposals from leading social scientists setting out ways that policy makers at a local level could improve the health of their communities and reduce health inequalities.

Background to the project

Forum with Sir Michael Marmot in Oct 2011 bringing together medical practitioners and social scientists

The Steering Group for the project

Jim McManus, Director of Public Health

Kate Pickett, Professor of Inequalities

Ian Gilmore, Professor of Medicine

Fiona Godlee, Editor of BMJ

Miles Hewstone FBA, Professor Social Psychology

Jane Roberts, Consultant Psychiatrist

Jessica Allen, Deputy Director of IHE at UCL

Antony Heath FBA, Professor of Sociology

What the project aimed to do• Build on the Marmot review and not replicate it • Give a good overview of some of the

socioeconomic factors affecting health inequalities and the evidence base for those areas

• Give a fresh perspective to an area that has already received a lot of attention

• An easy to read / accessible report that will appeal to policy makers at a local and national level, and to the broader public

The 9 interventions1. Implement a living wage2. Increase early childhood education3. Implement 20mph speed limits4. Tackle health-related ‘worklessness’5. Use participatory budgeting to improve mental capital6. Increase the scope of adult and further education7. Improve the employment conditions of public sector

workers8. Build ‘age-friendly’ communities and cities9. Evaluate policies for evidence of cost-effectiveness

1. Implement a living wage - Kate Pickett

• More unequal societies tend to have poorer health outcomes• A living wage will provide

– An incentive to work– A way out of in-work poverty– Improvements in work quality and productivity– Falls in absenteeism– Positive impacts on recruitment and retention– A way of directly addressing inequalities in health + wellbeing

• Practical action being taken by Fairness Commissions in York, Islington, Newcastle, Liverpool, Sheffield + Blackpool

2. Increase early childhood education – Edward Melhuish

• Need for provision of universal and high-quality early childhood education and care

• Needs to be high quality care – problems with Sure Start were that not all centres were providing sufficient high quality education and care

• Benefits population as a whole but even greater benefits for children from disadvantaged backgrounds

3. Implement 20mph speed limits – Danny Dorling

• People are at most risk of being hurt or killed by cars in the poorest parts of towns and cities.• Easily enacted at a local level, this literal slow down would reduce the risk of pedestrian - especially child - fatalities • Many UK cities and towns have already implemented it – Birmingham, Cardiff, Edinburgh, Islington, Newcastle...• Initial evidence from the UK suggests it is having a significant impact and there is longer term evidence from Sweden

4. Tackle health-related worklessness - Clare Bambra

• Being sick or disabled reduces an individual’s employment prospects• Health-related job losses are more likely in lower socio-economic groups• Focus on managing the ill health of those out of work first, rather than focussing on skills and employability• Following NICE guidance, County Durham implemented a health-first approach with promising results

5. Use participatory budgeting – Kwame McKenzie

• HWB should use participatory budgeting to make decisions on public health priorities and to choose interventions• LAs need to engage with the concept of mental capital and an effective way to do this is to increase the access of the most marginalised to influencing decisions and resource allocations• Results show that participatory budgeting provides more equitable spending, better quality of life, increased satisfaction and greater transparency• Been used in the UK for over 10 years with 150 projects

6. Increase the scope of adult & further education – Chandola & Jenkins

• A large part of health inequality is accounted for by poor health among those who leave school without any qualifications.• Research shows that adult learning is associated with better health and wellbeing• A successful policy framework would include:–Financial support for adults who left school with no qualifications–Literacy and numeracy courses for adults–Encouragement of greater participation in learning amongst older adults–Harnessing the role of further & adult education in prioritising needs at a local level

7. Improve employment conditions of public sector workers – James Nazroo

• Social and economic inequalities are the main drivers of ethnic inequalities in health• There should be substantial policy development in this area • There are large numbers of ethnic minority groups in the public sector workforce• LAs should set standards regarding good, equitable employment practices

8. Build age-friendly communities – Hal Kendig and Chris Phillipson

• Place matters and older people living in urban areas face issues around social integration, access to services, leisure and mobility

• Action to address these will improve the independence, participation, health and wellbeing of older people

• The WHO highlights the efforts of Manchester and York to become age-friendly cities

9. Evaluate policies for evidence of cost-effectiveness – Alan Maynard

• Local policy makers should prioritise the use of cost-effectiveness evidence when choosing interventions to reduce inequality

• Pilot any new practices, consider the results and share the findings

• Better use should be made of health economists and their value better recognised

• Without evaluation, inequalities will be preserved, at best, and more likely worsen

Aims of the report

To embolden local policy makers to broaden the range of policy approaches used to reduce health inequalities and tackle some of the trickier structural and economic issues such as planning, worklessness and income inequality, as well as behavioural issues such as smoking and alcohol abuse.

5 steps for embedding in policy making1. LAs need to own the fact that what they do influences

the health of their population2. Build good relationships with local academics in social

sciences as well as biomedical and behavioural3. Discuss across LAs the contributions which each

function can make to improving health4. Create a public health strategy which balances

behavioural and structural/societal interventions5. Evaluate interventions properly to ensure lessons are

learned

Contact and more information

Helen Haggart, Senior Policy Adviser h.haggart@britac.ac.uk

www.britac.ac.uk/policy

@britac_news