South West ambulance against a backdrop of a beach

Health Inclusion

A myriad of factors influence well-being, including health and work, which themselves can be intimately related. The impacts are not only economic but can also affect people’s life chances. Recent evidence also suggests that work can be good for health, reversing the harmful effects of long-term unemployment and prolonged absence as a result of sickness.

Tackling stigma around ill-health and disability is key in helping more people with health conditions into work and stay in work.

The economic costs of ill-health and its impact on work are measurable, but the human costs are often hidden and privately borne. For many people, work plays an important role in their self-esteem, identity and standing within the community, as well as affecting their economic independence and the opportunities for their families and children.

The Dame Carol Black Review in 2008 identified the need for support for working age health to span both improving health at work and support for workers with health problems to stay at work. This includes people who have not yet found work, or have become workless, to enter or return to work.

Dame Carol Black comprehensively reviewed the evidence and has set a vision that includes three principal objectives:

  • prevention of illness and promotion of health and well-being;
  • early intervention for people who develop a health condition; and
  • an improvement in the health of people out of work – so that everyone with the potential to work has the support they need to do so.

One person in four experiences mental ill-health in the UK each year – which means that if there are 100 employees there will be around 25 with mental ill health, most of whom will be suffering in silence. With the right support and the right job people with mental health problems perform vital roles in workplaces across the UK.

Work from Time to Change is very revealing:

  • ‘Nearly nine out of ten people (87%) with mental health problems have been affected by stigma and discrimination’ (2008).
  • In a recent study respondents said, fear of stigma had stopped them from telling their employer or prospective employer about their mental health problems.
  • In another, conducted in 2009, 92% of the public thought someone’s employment prospects would be damaged if they admitted to having a mental health problem.

Mental ill-health such as depression, anxiety, schizophrenia and bipolar disorder do not need to stop you from working. A failure to recognise this not only leads to a lack of productivity and a real impact on bottom line profits but is a missed opportunity to develop workers’ abilities and secure genuine assets in a workforce.

Improving the health of the working age population is critically important for everyone, in order to prevent the waste of human potential and secure both higher economic growth and increased social justice.

Unhealthy workforce slows the economy

  • lost productivity,
  • reduces income tax receipts,
  • increases in long-term sickness
  • and increases healthcare costs.

* from a presentation at the Public Health England (PHE) National Conference in 2017, from the report Health and Wellbeing in Rural Areas.

PHE and Healthy Working Futures, a workplace health provider, set out advice for SMEs in 2017, around ‘improving work health for a healthy economy‘.

Marmot Review and Indicators

Fair Society, Healthy Lives: The Marmot Review report was published in February 2010, presenting the recommendations of the Strategic Review of Health Inequalities in England post-2010. In February 2011, the first Marmot Indicators for local authorities were released, providing information to support monitoring of the overall strategic direction in reducing health inequalities. These indicators were updated in 2012.

Launched in September 2014 by the Institute of Health Equity, the Marmot Indicators 2014 were developed in collaboration with Public Health England. They are a new set of indicators of the social determinants of health, health outcomes and social inequality, that broadly correspond to the policy recommendations proposed in Fair Society, Healthy Lives.

Marmot Indicators:

Marmot Cornwall 2014 Indicators

Marmot Cornwall 2015 indicators

There have been no new sets of Marmot indicators releases since 2015, but the data for these two years covers

  • Healthy life expectancy at birth – males and females
  • Life expectancy at birth – males and females
  • Inequality in life expectancy at birth – males and females
  • People reporting low life satisfaction
  • Good level of development at age 5
  • Good level of development at age 5 with free school meal status
  • GCSE achieved (5A*-C including English & Maths)
  • GCSE achieved (5A*-C including English & Maths) with free school meal status
  • 19-24 year olds who are not in employment, education or training
  • Unemployment % (ONS model-based method)
  • Long-term claimants of Jobseeker’s Allowance
  • Work-related illness
  • Households not reaching Minimum Income Standard
  • Fuel poverty for high fuel cost households
  • Utilisation of outdoor space for exercise/health reasons

In 2020, the Institute of Health Equity produced a review of the Marmot report, 10 years on, which you can read on their website.

Institute of Health Equity report around employment

The UCL Institute of Health Equity was commissioned by Public Health England to produce a report that would illustrate how to reduce health inequalities through creating and promoting more employment opportunities in good work. It builds on a previous collaboration, culminating in the report ‘Local Action on Health Inequalities: Promoting Good Quality Jobs to Reduce Health Inequalities 2015’.

The way in which LEPs can shape job growth to take into account health inequalities, and how they can use job creation to help reduce these inequalities, are presented. 

Cornwall’s Joint Strategic Needs Assessment

Updated regularly, Cornwall’s JSNA allows the analysts to identify and monitor changes in

  • local health and wellbeing needs
  • inequalities of the local population

This then helps inform future service planning across the public sector. Here you can find:

  • local and national data
  • information and analysis
  • data to help to make decisions and plans to improve local people’s health and wellbeing
  • data to help reduce health inequalities across Cornwall and the Isles of Scilly

There is extensive information available, on the JSNA web pages.

The key resources are the area profiling tool Local Insight (communityinsight.org) which provides 50 page socio-economic profiles for a variety of geographies across Cornwall (inc. Isles of Scilly) i.e. towns, Community Network areas, Primary Care Networks etc. These are updated with any newly published data every 3 months, but also allow people to explore specific datasets using the mapping function as well.

There are also specific topic based papers available here: Reports and papers – Cornwall Council

Interesting information and links, include:

Current information and resources

  • NHS mental health support information
  • Cornwall Council’s mental health signposting pages
  • Do we have resources around MH & work specifically elsewhere
  • Pentreath – the award winning mental health organisation that strives to encourage improved awareness, health and wellbeing
  • Check out The Recovery Letters – letters written from people recovering from depression, addressed to those currently suffering. The letter writers have experienced different types of depression including clinical/major depression, bi-polar and post-partum depression.
  • Sea Sanctuary   Cornish mental health charity with a unique approach and the first of its kind to be commissioned by the NHS.

Older reports and announcements