Inclusive growth – turning rhetoric into reality

10 September 2018

Inclusive economic growth: if it was easy, every city would have cracked it. In July, Leeds City Council launched its inclusive growth strategy supported by ‘12 big ideas’. Is the strategy achievable, who is ultimately responsible for its success and what does an academic health partnership have to do with it?

Here, Leeds City Council’s Chief Officer for Economic Development (and a new member of the Leeds Academic Health Partnership’s operations group) Eve Roodhouse, offers food for thought.

Inclusive economic growth is a fundamental social determinant of health. It reduces health inequalities, helping people live healthier lives for longer. Or so the theory goes.

But what do these grand terms actually mean? What does inclusive economic growth look like in reality and what are the social determinants of health?

The Organisation for Economic Cooperation and Development (OECD), of which the UK has been a member since 1961, defines inclusive growth as ‘economic growth which is distributed fairly across society and creates opportunities for all’. Yet it also states that in many OECD countries, inequalities are at their highest levels in 30 years and are widening.

Those inequalities include health. The World Health Organisation (WHO) explains that ‘the social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels.’

Around the world, radical approaches have been tried in efforts to address these problems.

New York’s Montefiore Health System, which features as a recent King’s Fund case study, embraced an almost impossible, technically unfunded task of setting up and providing healthcare in the Bronx. At the same time, it contributed to that community’s recovery from economic deprivation.

As the King’s Fund reports: ‘…it decided to pursue risk-based contracts with insurers, taking a proportion of the financial risk of managing groups of patients in exchange for a proportion of the savings if it managed to improve the quality of care while bringing costs down. What is now a defined path was at that time a leap in the dark.’ Today it serves a population of around 3 million.

In a different approach, around 4,000 lower-income adults in Ontario last year received payments from the government with no strings attached. The objective of this funding pilot was to find out whether a basic income makes a positive difference to people’s lives. But, argues the Globe and Mail article, is it also an acknowledgement that a market economy leaves people out and behind?

Whatever one’s political persuasion, the economics speak for themselves. Spending on public health interventions has been found to provide a return on investment to the wider health and social care economy of 140 per cent.

Exploring the role of cities in achieving inclusive growth, the Joseph Rowntree Foundation explains that ‘responsibilities for inclusive growth must be shared between individuals, employers and the state.’

How are we doing in the UK?

In July, BBC Panorama’s  Get Rich or Die Young reported that the life expectancy gap between rich and poor people in England has been widening for nearly two decades. Based on a study by Newcastle University’s Professor Clare Bambra, it highlighted Stockton-on-Tees as ‘the most unequal town’.  It reported that reasons for the health inequality gap are complicated but the main one is income. Indeed, according to the Health Foundation, it is ‘largely accepted that access to health care only accounts for around 10 per cent of a population’s health, with the rest being shaped by socio-economic factors’.

It’s clear then than the challenge of reducing health inequalities lies way beyond the gift of an already strained NHS, however compassionate and giving that might be. More medicines or operations can’t change the social or economic backdrop in a person’s life, yet our health and care services continue to deal with the consequences of socio-economic inequalities.

How are we doing in Leeds?

As with any big, post-industrial city, Leeds has its challenges. Leeds Health and Wellbeing Board last year found that while the city is significantly better than the national (England) average in terms of statutory homelessness and violent crime, it is worse in terms of deprivation, child poverty and long term unemployment, all major determinants of good health. Life expectancy at birth of both males and females is also worse than the national average.

But Leeds has big ambitions. It aims to be ‘the best city for health and wellbeing’.

In June, the City Council launched its inclusive growth strategy, comprising 12 big ideas focusing on ‘supporting people, places and productivity’. Recognising the need for all sectors to work together to achieve its aims, the strategy invites industry and other organisational leaders to pledge how they intend to support it. Many have declared their pledges already and in doing so, surely acknowledge that there is a return on investment to be had by all, economically as well as socially, culturally and environmentally.

As the UK’s third largest and one of the fastest growing cities, Leeds has many strengths on which to build.  The Leeds Academic Health Partnership (LAHP) is bringing together industry, academic and health and care sectors to realise the immense growth and innovation potential of the Leeds City Region’s medical technologies sector. In a sector which is also growing exponentially around the globe, across the Leeds City Region it is set to bring significant economic growth along with sizeable benefits for its health and care sector, including improving efficiency and quality of care for patients.

Underpinning this, the LAHP is part of a select Leeds City Region team joining a prestigious leadership programme run by Massachusetts Institute of Technology (MIT), one of the world’s top universities. The two-year Regional Entrepreneurship Acceleration Programme (REAP) provides expert, evidence-based guidance for teams to bring about significant economic and social change in their region.

A core principle within one of our emerging projects, the Leeds Health and Care Academy, aims to not only attract talented people to come and work in Leeds, but to drive social mobility in the city. Working with partners and communities across the city, it will promote training in health and care careers, making them more accessible to people who may have previously felt those options were out of reach. Again, this reflects the LAHP’s strategic aim to drive inclusive economic growth.

Are we starting to see in practice one of the approaches recommended in The Marmot Review 2010: Fair Society, Healthy Lives.[1] ‘Effective local delivery requires effective participatory decision-making at local level. This can only happen by empowering individuals and local communities.’

As Chief Officer for economic development at Leeds City Council, I am now in the privileged position of being able to help strengthen the vital links between all sectors which all play a part in achieving inclusive economic growth for the city.  I will be drawing on my experience of driving strategic, national transformation across the NHS to now work locally with industry, local communities and cultures, the local authority and the city’s health and care sectors.

As part of this, my new role also involves joining the LAHP’s operations group — the breadth and strength of collaboration across its membership means that together we can confidently say we’re striding in the right direction.

Ends

[1] http://www.instituteofhealthequity.org/resources-reports/fair-society-healthy-lives-the-marmot-review, executive summary, p9.