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Health is going in the wrong direction in the UK, and reversing the trend requires political and societal commitment to deal with the underlying causes
The UK is facing a prolonged and serious health crisis. At a time when the future of the NHS is in jeopardy after over a decade of austerity, and with public satisfaction at an all time low,1 it must pick up the pieces of failures across government. Attaining good health requires more than healthcare, and improvements in the provision of healthcare by the NHS alone is inadequate to address the health crisis action is needed on the social determinants of health2 (box 1).
Box 1 ### Definition of social determinants of health3
The social determinants of health are defined by the World Health Organization as: “the conditions in which people are born, grow, live, work, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and syste ....
In this election year, politicians must give us hope for a better future, writes Michael Marmot
“Hope is an orientation of the spirit … an ability to work for something because it is good…. It is not the same as optimism. It is not the conviction that something will turn out well, but certainty that something makes sense regardless of how it turns out.”1
So said Václav Havel, playwright, dissident, and President of post-communist Czechoslovakia. He had been through it all before he played a key part in his country toppling communism and emerging blinking into the light. The UK in 2024, and at the beginning of an election year, is experiencing dark days of a different sort: population health has stopped improving and health inequalities are increasing. That means that the conditions in which people are born, grow, live, work and age have stopped improving or are deteriorating.
Demoralisation and pessimism about prospects for improvement abound, with version ....
Author summary Why was this study done? Joint replacements are among the more frequent elective surgeries performed in developed settings. In England, inequalities in provision of joint replacement surgery were reported more than a decade ago, followed by a national effort to reduce these inequalities. In a context of increasingly strained National Health Service funding and hospital budgets, alongside prolonged efforts to increase surgical capacity, it is unclear what impact these have had on inequalities in provision of joint replacement for osteoarthritis. What did the researchers do and find? We conducted an analysis of the National Joint Registry using all primary hip and knee replacements for osteoarthritis performed from 2007 to 2017 in England, merged with the Office for National Statistics official population statistics, to investigate inequalities in provision of surgery according to deprivation by patient area of residence, age, sex, and trends in these inequalities ov ....