Agenda item

Report by Corporate Director of Public Health.

Oxfordshire faces significant inequality despite being a county of relative high affluence. A range of work programmes exist that see to address these inequalities, but there is not a unifying umbrella or methodology that guides these activities, and it is difficult to know how effective the range of action is.

This paper summarises an opportunity to partner with Professor Michael Marmot’s Institute of Health Equity (IHE) who are the leading international experts in approaches to addressing social determinants of health to review our current activity and support more effective action going forward.

The strategic aims of this partnership would be to:

1. Provide a high-quality evidence based external review of the range of activities happening in Oxfordshire to tackle health inequality and inform potential gaps.
2. Act as a glue to bring together all activities to tackle health and social inequalities across Oxfordshire.
3. Provide a corporate evaluative framework for above initiatives across Oxfordshire.
4. Enable to measure rural inequality and take effective actions.
5. Mobilise our policy research to find innovative solution to tackle health inequality and help secure external funding for future work.

This approach supports the implementation of the Oxfordshire Health and Wellbeing Strategy agreed by the Board in December 2023.

RECOMMENDATION

The Health and Wellbeing Board is RECOMMENDED to

Endorse the proposed partnership with the Institute of Health Equity to develop Oxfordshire as a Marmot Place to advance our local programmes of work to tackle health inequalities in Oxfordshire, noting the rationale for this work and its connection into the new Oxfordshire Health and Wellbeing Strategy.

Agree to act as the existing system partnership board that has oversight of the developing Marmot Place work programme, and receive updates on progress at future Board meetings.

The Chair introduced David Munday, Deputy Director of Public Health, to provide an update on the Marmot Place initiative. He raised the following points:

-       Noted that ill health was not geographically spread across Oxfordshire, but clearly evident in areas of higher proportion of ethnic minorities, people in vulnerable housing and homeless people and people living in rural areas who may be more isolated.

-       It was made clear that the drivers to improve ill health were known as the building blocks of health, such as education, housing, employment, access to green spaces and clean air.

-       It was clear that there were good opportunities in partnership with the Marmot Institute in a two-year programme of work to provide an overarching framework for different local initiatives, particularly noting the challenge of rural inequality that is faced within Oxfordshire.

-       Helping with research with academic colleagues and innovation to try and address inequalities.

-       Seeing the Marmot Place initiative as a new methodology to wrap together different initiatives together.

-       Looking at how the 8 ‘building blocks of health’ can be best addressed.

Cllr John Howson, Cabinet Member for Children, Education and Young People’s Services, commented that it was important to not work in silos and to work with the education sector to see how it could be developed.

Cllr Dr Nathan Ley, Cabinet Member for Public Health, Inequalities and Community Safety, noted the importance of addressing rural health inequalities and referenced the launch event in November as an opportunity to work with community leaders. He also noted that the Marmot principles were overlapping and thus, it was difficult to choose two to initially focus on.

David Munday agreed that it was difficult to disagree with any of the Marmot principles, but that advice from the Marmot team was that work would be too thinly spread if you were initially across all eight principles at the same time.

Ansaf Ahzar, Director of Public Health and Communities, noted that this was an exciting opportunity for Oxfordshire as Michael Marmot was an international expert in tackling inequality and used Coventry as an example of this working over a period of time, despite national trends being in the opposite direction.

Don O’Neal, Chair – Healthwatch Oxfordshire, stated that Healthwatch had recently completed a report into rural and health inequalities and that he would be happy to share that.

The Vice Chair asked about the scope of the project beyond the initial two years. Ansaf Ahzar noted that two years was the just the start of the project.

The Chair noted that Oxfordshire would be different to Coventry due to the rural nature of the county and pointed out the work that had been taking place in deprived urban areas, but that finding pockets of rural inequality would be crucial to this body of work.

Cllr Dr Nathan Ley raised concerns about metrics in Cornwall going in the opposite direction having become a Marmot Place. Ansaf Ahzar responded that it is important to allow time for work to develop and that Coventry was a good example to judge as it was one of the first areas that became a Marmot Place.

The Chair asked about where the priorities would be determined and how often the Health & Wellbeing Board should be updated about progress. David Munday confirmed that the Steering Group would take forward the mapping out of priorities and expected that frequency of updates would be decided upon over time.

Cllr Chewe Munkonge, Oxford City Council, asked if funding arrangements over the next 3 years were sufficient and if there were plans for future funding arrangements beyond that time period. David Munday responded that the money was to facilitate partnership working, but that more would be needed to take forward the programmes of work.

RESOLVED to:

Endorse the proposed partnership with the Institute of Health Equity to develop Oxfordshire as a Marmot Place to advance our local programmes of work to tackle health inequalities in Oxfordshire, noting the rationale for this work and its connection into the new Oxfordshire Health and Wellbeing Strategy.

Agree to act as the existing system partnership board that has oversight of the developing Marmot Place work programme, and receive updates on progress at future Board meetings.