Study finds reductions in public health are associated with poorer health

Cuts in public health spending during the austerity era have been associated with increased health problems, according to a new study published by The Lancet.

The authors of the study, which was funded by the Medical Research Council, urged policy makers to “consider the potential health consequences of local government spending cuts and the ripple effects on health systems.” health”.

When researchers looked at the relationship between changes in overall council spending over an eight-year period from 2009-2010 with multimorbidity (people with two or more long-term conditions) and quality of life related to health, they found that a 1% reduction in total service expenditure per capita was associated with a 0.1% increase in multi-morbidity, but there was no association with quality of life related to health.

When they looked at budget lines and controlled for other spending, they found that a 1% reduction in public health spending was associated with a 0.15% increase in the prevalence of multimorbidity, and that a 1% reduction in adult social care expenditure was associated with a 0.01% decrease in mean health-related quality of life.

They write: “Our results suggest that reductions in total local government spending are associated with an increased prevalence of multi-morbidity.

“Our estimates suggest that the average reduction in total service expenditure of 22% between 2009-2010 and 2017-2018 was associated with an average increase of 2.2 percentage points in the prevalence of multimorbidity.

“In particular, multimorbidity appears to be associated with public health expenditure per capita and health-related quality of life with social care expenditure.”

They say their findings have “potential implications for any future contemplation of austerity cuts”, noting that the Institute for Fiscal Studies said spending will still be significantly lower for local governments in 2024-25 than in 2010. , and that some councils may still have to reduce additional services over the next few years due to increased financial pressures.

They write: “Policymakers should consider that any cuts in funding for broader local public services could have implications for rising future health service costs and diminishing population resilience to future pandemics. or other shocks.

“These deteriorations in the health of the population would be difficult to reverse. In particular, national policy makers involved in determining subsidy formulas should aim to integrate these trade-offs between short and long-term funding, and to better reflect the additional dependence of some communities, the poorest, on of this public investment.

David Fothergill (Con), chairman of the Local Government Association’s Community Wellbeing Council, noted that councils had seen more than £1billion in cuts to their public health grant over the past seven years, with the greatest reductions in disadvantaged areas with the highest levels of health inequalities. .

He added: “It is clear from this report that these cuts have had a detrimental impact on health outcomes, with council spending cuts causing more pressure on the health and social care system down the line. .

“A long-term increase in the councils public health grant will ensure that vital services such as tackling childhood obesity, drug treatment and the recruitment of more medical visitors, all of which have seen increased demand over the past few years, are fully funded to meet the challenges ahead.

A government spokesperson said: ‘Tackling public health issues and improving the health of the nation is a top priority for the government, and later this year our health disparities white paper will define a series of measures to help people live longer, healthier lives. physical and mental health.

“We are also providing over £3.4 billion to local authorities through this financial year’s public health grant, which will allow them to continue to invest in the prevention of health problems and in essential services such as such as child health visits, addiction treatment and sexual health. services.”