A crucial union of business and place

By Sir Nigel Wilson | 12 April 2022

During Parliament’s Levelling Up Health launch last year, stark analysis revealed that 40,000 fewer people would have died during the pandemic if the most deprived areas in the UK had the same health record as the most prosperous.

Another eye-opening statistic estimates that, pre-pandemic, 30% of the shortfall in productivity in the Northern Powerhouse compared with the rest of England was due to ill health.

Areas which have suffered most from austerity and cuts to public services have also clearly seen a correlated fall in healthy life expectancy. In the UK, the rich-poor gap in healthy life expectancy is almost 20 years, with those in the most deprived areas not only having shorter lives, but also spending nearly a third of their lives in poor health.

It is increasingly clear, therefore, that place plays a crucial role in addressing health inequalities – and the need to support health and wellbeing throughout our communities has never been more clear than over the last two years.

As with so many social issues, this is something which business needs to work together with government and local places to address. Up until now businesses have not taken an active role in addressing health inequalities on a major scale. That is why Legal & General and the UCL Institute of Health Equity have formed a four-year partnership that this month launched a major review of health inequities, setting out a roadmap for the role of industry in levelling up – The Business of Health Equity: The Marmot Review for Industry. For the first time, the review examined how we bring business together with local government and the voluntary and community sector to make a real difference to the conditions in which people are born, grow, live, work, and age – to increase health equity.

What we learn from our partnership and our research has the potential to help other businesses in the UK. We want to encourage uptake among the business community and enable other corporations to enhance their social, economic and health equity roles. We have already spoken to multiple FTSE 100 business leaders who look after the interests of millions of employees. They are keen to use their positive influence to tackle health inequalities, and we trust this report will support their efforts.

The Marmot Review for Industry sets out three ways that business can improve people’s lives by reducing health inequality. These include:

  •  promoting the health of employees through pay and benefits, hours and job security and conditions of work
  • supporting the health of clients, customers and shareholders through products and services they provide and the investments they make, and
  • influencing the health of individuals in communities through investment influence, procurement, and supply networks.

One key role where we believe we can help is by being an active funder in communities up and down the UK. As just one example, poor housing harms health and evidence shows that poor housing conditions (including damp, cold, mould, and noise) are strongly associated with poor health – both physical and mental. With house price inflation of more than 14% in the 12 months up to February this year – the highest in 17 years – we desperately need more housing, especially affordable and social housing. Legal & General is investing to provide thousands of new, sustainable affordable homes across the UK, but we recognise that austerity has left many authorities unable to fund initiatives that could improve the lives of other people and families in this situation. This is why, as part of our partnership, we will be exploring ways to provide revenue that funds new, place-based initiatives that tackle health inequality and its determinants, supporting levelling up across the UK’s regions.

The Fund will sit alongside, and provide resources to, a new Legal & General IHE Network for UK public authorities and businesses to support idea creation, sharing of best practice and insight, and innovation that can help increase long-term healthy life expectancy and reduce health inequalities. In addition to the ‘Marmot Places’ of Coventry and Greater Manchester, we’ve already had towns, cities, and combined authorities signing up to this network, and look forward to the gatherings and sharing of knowledge that will no doubt result. Please do get in touch with us if you’d like your place to join – it’s free of charge.

As companies can influence the environment with their businesses, buildings, and behaviour, so too can they influence health outcomes. Businesses and environment, social and governance (ESG) investors are playing a critical role in reducing carbon emissions. ESG’s ‘E’ is working, but the ‘S’ is further behind – the impact of corporate activity on population health and its associated costs is not currently adequately addressed. Post-COVID, there is a strong case to consider health and health inequality as crucial to the ‘S’ of ESG. We are explicitly calling out health within a new ‘ESHG’ investment framework.

The health challenge is just as urgent as the environmental crisis – and it affects people and families across the UK. When the full weight of an industry is deployed to solve a social problem, in partnership with places across the UK, meaningful change can happen rapidly. That is our best hope for bringing an end to the injustice of health inequality.

Sir Nigel Wilson is CEO of Legal & General


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