Gestor bibliográfico Crisis y Salud

Health inequalities in London are stark. Between London boroughs there are life expectancy gaps of 9.1 years for men and 8.7 for women, and healthy life expectancy gaps of 11 years for men and 10.5 for women. Within borough differences can be even bigger - the difference between men in the tenth of the population with the worst and the tenth with the best life expectancy in Westminster is 17 years. Across England health inequalities are widening. The reasons for such large and widening inequalities relate to inequalities in the social determinants of health, the social and economic factors which shape peoples' lives and their health. In this review we assess three important social determinants of health - housing, income and employment - and their likely impact on health inequalities in London in the context of the ongoing economic crisis and the Government's welfare reforms. This literature review is the first stage in work aimed at assessing and monitoring the impact of the recession and welfare reforms on health inequalities in London and it makes for sober reading. Improving health and reducing health inequalities in this macro-economic environment is going to be a great challenge. Rising unemployment, poorer working conditions, depressed incomes and an inability to pay for decent housing and basic needs will all increase negative mental and physical health outcomes across the social gradient and especially for more vulnerable groups. Those unemployed for long periods of time will be more likely to be unemployed in the future, and higher levels of parental stress will lead to worse outcomes for many of the children of this generation. The report highlights the importance of sufficient incomes, decent housing and active labour market programmes, focused on those groups most at need. But how can cash-strapped boroughs make this happen? This report provides suggestions, and will be used as the basis for local tools to enable targeted action on the priority risk areas. Over the coming months, an indicator set will be developed to measure potential impacts of the changes. This should assist boroughs planning services and anticipating the health and well-being of their populations.