What are the eight Marmot Principles and how could they transform the health of a local area?

More than 43% of the UK population now live in a Marmot Place, a local area which has committed to deliver on principles which will improve health equity.

There is no national health inequalities strategy in England, nor any requirement for places to tackle health inequalities in this collaborative, place-based way – so it is so encouraging to see this locally-led grassroots movement involving places across the political spectrum.

There are more than 60 Marmot Places, which cover large regions such as Greater Manchester and Cheshire and Merseyside, the whole of Scotland and towns such as Luton and Kings Lynn, rural areas, coastal regions, large cities, islands, wealthier places with pockets of deprivation and large cities suffering the effects of deindustrialisation.

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All places use the framework of the eight Marmot Principles, which were first developed for the first Marmot Review in 2010 by Micheal Marmot, professor of epidemiology and public health at University College London. They are based on evidence about the main drivers of health inequalities locally, nationally and globally:

1. Give every child the best start in life
2. Enable all children, young people and adults to maximise their capabilities and have control over their lives
3. Create fair employment and good work for all
4. Ensure a healthy standard of living for all
5. Create and develop healthy and sustainable places and communities
6. Strengthen the role and impact of ill-health prevention
7. Tackle racism, discrimination and their outcomes
8. Pursue environmental sustainability and health equity together

Working with communities and partners we review any inequalities in these eight Marmot Principles, setting out particular issues of concern. We report where progress has been made and highlight what is working well to be built on.

The IHE’s Marmot Places programme has responded to unmet need in many places wanting to do more to improve the health of their residents. In Scotland, where national leadership and involvement is evident, it has been enormously beneficial in formulating new ways to take national action and encourage local action.

In England, national leadership has much to learn from the endeavours of English Marmot places, determined to challenge health inequalities, however hard the circumstances. The work is complex and challenging, but we have seen such positive impacts.

Jessica Allen is deputy director at University College London’s Institute of Health Equity.

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