THE GAP in infant mortality rates between English local authorities narrowed between 1999-2010, but that trend has been reversed since 2011 as a result of Tory austerity measures, a new report suggests.
Under the Labour governments from 1999-2010 inequalities between the most deprived areas of England and the rest of the country were reduced, having a positive impact on infant mortality rates, according to research by the Universities of Newcastle, Leeds, York, and Liverpool published online in the Journal of Epidemiology & Community Health.
However, the authors say, the austerity policies of the Tory governments since 2010 seem to have undermined these gains because the trend in decreasing inequalities has not continued.
When the 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 (eg via tax credits and introducing the minimum wage).
A range of social programmes such as SureStart were funded and there were 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.
For this study the authors examined what impact 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.
They found that before 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 three 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 four deaths per 100,000 births per year.
There was also a marginal decrease in relative inequalities during the strategy period.
This is an observational study, and as such, can’t establish causality.
The authors also highlight that their results may have differed if they had used infant survival rather than infant mortality as an outcome measure, or occupational class rather than geographical area as a measure of deprivation.
The observed decrease in inequalities in the infant mortality rate may also have been impacted by broader government strategies rather than the health inequalities strategy alone, they add.
Nevertheless, they say: ‘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.’
They add that the findings have important implications for current and future health policy.
‘Our 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,’ they conclude.
- In a test case victory for a group of working lone mothers, the High Court found last week that the way the Department for Work and Pensions (DWP) has been assessing income from employment through its Universal Credit (UC) work assessment periods is unlawful.
Lord Justice Singh and Mr Justice Lewis ruled that the DWP has been wrongly interpreting the Universal Credit regulations.
They said in their judgment that treating claimants as having earned twice as much as they do if they happen to receive two pay cheques in one monthly assessment period, and as having no earnings in the next assessment period is ‘odd in the extreme’ and ‘…. could be said to lead to nonsensical situations.’
They added that the DWP’s incorrect interpretation of the regulations had caused ‘…severe cash flow problems for the claimants living as they do on low incomes with little or no savings’.
The mothers all had monthly paydays that ‘clashed’ with the dates of their monthly Universal Credit assessment periods, with the result that if they were paid early some months, because their payday fell on a weekend or bank holiday for example, they were treated as receiving two monthly wages in one assessment period – which in turn dramatically reduced their UC award – and as receiving no wages at all the next month.
This is a problem which has affected many working claimants and has been widely reported in the press.
CPAG’s solicitor Carla Clarke said: ‘Our clients have been doing everything they can to support themselves and their young children through work but the rigid assessment system in UC has caused them untold hardship, stress and misery with them being forced repeatedly to manage on half of their usual total monthly income despite their fixed outgoings remaining the same.’
Tessa Gregory, solicitor from Leigh Day, said: ‘It is extraordinary that when this issue was first raised, the Secretary of State did not act quickly to remedy the problem, instead choosing to fight these four women in court arguing that the system was fit for purpose despite the hardship being caused to working families.
‘This is yet another demonstration of how broken Universal Credit is and why its roll out must be stopped.’