The gap in infant mortality rates between English local authorities narrowed between 1999-2010, but that trend has been reversed by austerity measures.
Efforts by the Labour government to reduce inequalities between the most deprived areas of England and the rest of the country had a positive impact on infant mortality rates. The current Conservative government’s austerity policies may have undermined these gains because inequalities in infant mortality rates have increased since 2011.
When Tony Blair’s New Labour government came to power in 1997, it attempted to use policy levers to reduce geographical health inequalities in England. There was a focus on early years, education, supporting families, engaging communities in tackling deprivation, improving prevention, increasing access to healthcare and tackling the underlying social determinants of health (e.g. via tax credits and introducing the minimum wage). A range of social programmes such as SureStart were funded and there were large funding increases for the NHS and other public services.
However, when the Conservative–Liberal Democrat coalition took control in 2010 this strategy was replaced with austerity measures intended to reduce the national deficit.
This study examined what impact New Labour’s policies had on health inequalities by measuring inequalities in the infant mortality rate between the most deprived local authorities and the rest of England before, during and after its health inequalities strategy was put in place.
Before New Labour’s health inequalities strategy (1983–1998), the gap in the infant mortality between the most deprived local authorities and the rest of England increased at a rate of 3 infant deaths per 100,000 births per year. During the strategy period (1999–2010), the gap narrowed by 12 infant deaths per 100,000 births per year and after the strategy period ended (2011–2017) the gap began increasing again at a rate of 4 deaths per 100,000 births per year.
The multifaceted English health inequalities strategy, implemented between 1999 and 2010, was associated with a decrease in geographical inequalities in the infant mortality rate between the most and less deprived English local authorities. These results imply that government policies specifically introduced to decrease inequalities in health may be beneficial, and that their discontinuation as a result of austerity may see inequalities increasing again.
The findings have important implications for current and future health policy. The analysis suggests that it is increases in public spending on healthcare and welfare that are associated with decreases in inequalities in the infant mortality rate, and this is something that should be learnt from by current and future governments. Current government policies are arguably going in the wrong direction and may squander some of the gains made in the health inequalities strategy period.
Full paper available Open Access
Robinson T, Brown H, Barr B, Fraser L, Norman P & Bambra C (2019) Investigating the impact of New Labour’s English health inequalities strategy on geographical inequalities in infant mortality: a time trend analysis. Journal of Epidemiology & Community Health