2008: The Department of Health asked Professor Sir Michael Marmot to review the evidence regarding the causes of health inequalities in England and recommend action to reduce them.
2010: Marmot Review Fair Society, Healthy Lives was published and heavily influenced the 2010 Public Health White Paper and Public Health Outcomes Framework. Source.
The six domains recommended in the 2010 and 2020 Marmot Reviews to reduce health inequalities include:
- Give every child the best start in life
- Enable all children, young people, and adults to maximise their capabilities and have control over their lives
- Ensure a healthy standard of living for all
- Create fair employment and good work for all
- Create and develop healthy and sustainable places and communities
- Strengthen the role and impact of ill health prevention
In 2022 the Institute of Health Equity (IHE) added another two principles to reflect increasing recognition of the health equity impacts of these domains:
- Tackle racism, discrimination and their outcomes
- Pursue environmental sustainability and health equity
2013: Coventry became a Marmot City, taking a whole-systems, assets-based approach to adopting the Marmot Review policy objectives. Being a Marmot City is therefore not a clearly defined intervention, but an approach to developing and delivering change across services, civic functions of the council and community-led action. It is important to acknowledge that being a Marmot City did not bring any additional resources, at a time of austerity and unprecedented cuts from central government to local authority and public sector budgets.
The aims agreed by founding members of the Marmot Partnership were to:
- Identify key areas of existing and potential action to improve the life opportunities of Coventry residents.
- Maximise partner agencies’ capability to reduce health inequalities.
- Work in partnership to develop and implement a programme that will tangibly demonstrate an accelerated pace of change in addressing inequalities in the city.
- Maintain an overview of progress against an agreed local Marmot Indicator set.
2016: The programme was reviewed and refreshed with the same aims but with a reduced number of priority areas to provide clearer focus, aligning with the council’s priorities for Coventry. The new priority areas for action were:
- Tackling inequalities disproportionately affecting young people.
- Ensuring that all Coventry people, including vulnerable residents, can benefit from ‘good growth,’ which will bring jobs, housing and other benefits to the city.
2020: An independent evaluation of the six years that Coventry had been a Marmot City was conducted. The evaluation highlighted the role of the Marmot Partnership and senior leaders in influencing functions from planning, housing and transport to licensing, regulation and procurement; and provided leverage to get health equity into all policies, shaping the way services are commissioned and located, and the action taken on the priority areas for action. The data collated as part of the evaluation showed that Coventry performed well relative to national trends and comparable towns and cities; against a decade of austerity; cuts to public sector grants and fewer resources which contributed to health inequalities getting worse.
Acknowledgements
The Marmot Partnership would like to thank all partners from across Coventry services for their time, expertise and many contributions that have provided evidence, data and information for this monitoring tool.