Introduction

The next government has the power to bring about a happier, healthier Britain, but avoidable health inequalities are undermining society’s physical and mental health as well as our social and economic future. Health inequalities are unjust and harming Britain.

We brought more than 50 grassroots community organisations together to create this manifesto, developed through a series of engagement events on the issues that matter most to the thousands of local people they support.

Please sign up if you want to play a part or hear more in the promotion of our manifesto, either in your area or nationally. Email policy@peopleshealthtrust.org.uk to join our campaign.

Why this matters

Life expectancy is flat-lining and even reducing in our most disadvantaged communities. The gulf between how much of people’s lives is spent in good health has widened to 20 years in England and Wales and 25 years in Scotland. There has been no real positive progress since the 2008 financial crisis, and it is resulting in years-long hospital waiting lists, growing numbers of people with multiple long-term conditions, and growing levels of destitution.

Discrimination and stigma are increasingly widespread and affecting the physical and mental health of racialised communities, disabled people, LGBT+ communities and low-income households.

The consequences have been severe for our society, our health, and our economy.

Addressing health inequalities can only be achieved through making sure we address the building blocks of health, such as our homes, jobs, income, social connections, and community power.

Key statistics

  • More than 2 million homes in England contain urgent ‘Category 1’ Hazards, and more than one in five people in Wales live in homes with damp or mould. Poor housing conditions are linked to heart conditions, respiratory conditions, mental ill health and premature death.
  • A reported 3.9 million people were unable to meet their basic needs to stay warm, dry, clean and fed in the UK in 2022. This is increasingly affecting children and disproportionately impacts disabled people and Black, Caribbean and African communities.
  • 30 per cent of 18 year olds in the UK are not in education or training, leaving them likely in low-skilled work or unemployed. Unemployment and low-skilled work are both closely associated with long-term physiological health issues and mental ill health.

We call on the next government to:

Develop a strategy for sustainably funding local authority housing enforcement and monitoring its effectiveness

We welcome the proposed extension of the Decent Homes Standard to the private rented sector and the new regulations brought in through the Social Housing (Regulation) Act in England, the commitment to introduce a new minimum housing standard across all tenures in Scotland, and the new Welsh Quality Housing Standard and Renting Homes (Wales) Act.

We are calling for a long-term strategy for local authorities to fund widespread and equitable housing enforcement, including a review of the current funding system which is failing to ensure local authorities have sufficient capacity.

Reform Universal Credit to reduce the impact of the five-week wait and introduce the Essentials Guarantee so that payments cover the costs of essentials

One critical measure to help tackle rising destitution is to ensure that Universal Credit always keeps pace with the rising cost of essentials. This is what Joseph Rowntree Foundation (JRF) and Trussell Trust call for in their Essentials Guarantee.

Research from JRF suggests that the Essentials Guarantee would benefit everyone in receipt of Universal Credit and lift around 1.8 million people out of poverty altogether, including 600,000 children.

In addition to the Essentials Guarantee, we believe a future government should make changes to mitigate the impacts of the five-week wait for Universal Credit and consider other changes to make the system more accessible and supportive.

Commit to reform apprenticeships and expand young people's access to training and employment opportunities

It has been more than ten years since the Richard Review of Apprenticeships, so we call on the next government to commit to reviewing and reforming the system, learning first hand from young people and employers on how to improve the system. The goals of this review should be to expand access to a wider range of industries, increase the proportion of apprenticeships at entry level, and ensure these are accessible to young people in all communities across the UK.

Invest in local employment support for communities least likely to have access to good work

Support to access and remain in good work requires tailored activities from sources people trust. When this is delivered by and for communities with specific expertise in the needs of the local community, the support is more likely to include the right knowledge and skills.

Commit to expanding the rights of local communities to shape local services and priorities

We are a founding member of the We’re Right Here campaign which is working towards ensuring communities are given the voice they need to make the changes they want locally and calls for a Community Power Act. We echo this call.

Introduce cross-government responsibility for addressing health inequalities, including the introduction of a health inequalities strategy

Health in All Policies approach, where health impacts are considered within every policy and its implementation, has been found to support poverty reduction, education, urban development, good work and economic growth. We call on the next government to implement this approach alongside a comprehensive national health inequalities strategy, ensuring there is clear leadership and accountability for cross-government coordination, delivery and impact.

Download the report to read our full set of recommendations.

How this manifesto was created

We spoke with grassroots community organisations representing thousands of people about the solutions they believe are needed to reduce health inequalities in their communities. The communities represented cover the breadth of England, Scotland and Wales. We heard from organisations working with young people, older people, disabled people, minority ethnic communities, Gypsy, Roma and Traveller communities and many other groups with shared identities or experiences who face a high level of disadvantage. The recommendations presented here arise directly from their experience and knowledge on the ground.

Looking at the priorities, they feel obvious. They’re common sense. It’s a real shame that they’re not common sense for policymakers.”

People's Health Trust funded partner

What next

By adopting the policy recommendations in this manifesto, the next government has the opportunity to set the UK on a path to better health, stronger communities, and a brighter economic future.

We will be working with our partners and network to promote the findings and recommendations to all political parties with a view to securing commitments in political manifestos for an upcoming general election. We want to talk to you about how we start making this happen. Speak to us, learn more from our funded partners, join our campaign.

Please sign up if you want to play a part or hear more in the promotion of our manifesto, either in your area or nationally. Email policy@peopleshealthtrust.org.uk to join our campaign.