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Social determinants of health and the role of local government

The examples and case studies detailed in this report express the opportunities for health improvement and what has already been achieved.

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Health improvement has always been a fundamental responsibility of local government and this was emphasised further with the transfer of public health responsibilities in 2013. It is now seven years since that transfer. It is 10 years since the landmark publication of the Marmot report, ‘Fair Society Healthy Lives’ and it is also 10 years since the LGA last produced a report on the social determinants of health.

The role of local government at that time was set out as the following: as an employer; through the services it commissions and delivers; through its regulatory powers; through community leadership; through its well-being power. Local government still has all these roles in improving health and tackling the social determinants of health, but the world has moved on over a decade and the developments during that time are considerable.

Therefore, it the right time to look again at what local government can do to improve health especially by tackling social determinants. There are opportunities to see what innovation and new activity has been undertaken across the country and how that can be repeated elsewhere. In the context of COVID-19 it is important to remember that it is often the effects of social determinants of health that have made people more vulnerable to the virus. Conversely the social effects of the virus on employment and the economy will have an additional impact on health.