New data published in December showed that healthy life expectancy in England and Wales has fallen below 2017-19 levels. The gap between the most and least deprived areas of England has now reached 19 years for men and 18 years for women—a shocking reminder that where you live can still determine how long and how well you live. Tackling this will not be achieved through action from Whitehall alone; local areas need to be empowered to act on the building blocks of health, such as decent housing, a stable job, and a good education. 

For those of us advocating for greater support to local areas in addressing these inequalities, there were some glimmers of hope last year. The first was the publication of the Devolution White Paper, which made 44 encouraging references to improving health. Importantly, it gave a new duty around health improvement and health inequalities to Strategic Authorities. This new responsibility ensures that all Strategic Authorities will have a stake in improving local health outcomes, bringing us closer to realising a ‘health in all policies' approach.