Marmot review: 10 years on

A review of how things have progressed in the 10 years since the Marmot Review was published, highlighting the health inequalities across the UK, and the health gap between the rich and poor.

10 years ago Marmot published the Marmot Review, highlighting the health inequalities across the UK, and the health gap between the rich and poor.

The latest report has shown that the gap has widened, and that the government has failed to prioritise health inequalities, despite the evidence published 10 years ago.


  • Life expectancy has stalled – for the first time in 100 years. ‘If health has stopped improving it is a sign that society has stopped improving.’
  • There is a social gradient to life expectancy, people in more deprived areas live shorter lives and the gap is widening
  • Women in the 10% most deprived areas saw a decrease in life expectancy over the last 10 years
  • Health is linked to the social determinants of health - the conditions where people are born, grow, live, work and age, not just how well the health service is funded. Large funding cuts have affected the social determinants of health, and the cuts have been greatest where the need is higher.
  • Healthy life expectancy (years free from disability) is also closely related to deprivation levels. Those in the most deprived areas not only have shorter lives, but spend more time in ill-health too
  • Health inequalities are avoidable, unjust and linked to social and economic conditions. 
  • Health is worse in the North compared with South of England. Proportionately greater investments are needed to reduce these regional health inequalities.

Greater Manchester – a Marmot Region

The report also highlights some of the successes across Greater Manchester, as a result of devolution. These successes have been particularly visible in: reducing inequalities in early years, community cohesion and system wide approaches.

Marmot states that unified public services have enabled the development of place-based population health to tackle health inequalities through the social determinants.

Wigan was used as a case study for a systems-wide approach to reduce health inequalities, highlighting the tangible outcome of the proportion of adults who are physically active increasing by 15% in five years.

“The citizen-led, asset-based approach to health used in Wigan is regarded as an effective way to build and sustain communities and system-wide commitments”

The evaluation of Greater Manchester shows the value in devolved public services, who have the freedom to work collaboratively across sectors and prioritise prevention, in order to create a fairer, more equal society.

A case study of Greater Manchester's work can be found here.

Full report and exec summary can be found here.