Our health is shaped by the environment in which we are born, grow, live, work and age. A safe and warm home, a good job and strong relationships with neighbours, friends and family are all key to our wellbeing. It is estimated that social, environmental and economic factors are responsible for at least half of our health. 1 These ‘wider determinants’ are part of a broader system of influences on health, from the individual to the global level, which is commonly presented as shown in Figure 1.
Source: Dahlgren and Whitehead (1991)
These various social and environmental influences play a central role in driving inequalities in opportunities and outcomes, which accumulate over time and have a major impact on people’s physical and mental wellbeing. The report of the Marmot Review in 2010 made a number of evidence-based recommendations for addressing the social determinants of health across different stages of people’s lives, as summarised in the framework for action presented in Figure 2.
Source: The Marmot Review 2010
Hackney and the City of London are thriving inner London areas, home to a diverse, young and mobile population. Economic growth and social change in recent years has brought significant benefits to the local area, but these have not been shared equally across all sections of the population. As a result, there is a sense that social inequalities, and associated health inequalities, may be growing. 4
This chapter provides an overview of the main social and environmental influences on health in Hackney and the City today, highlighting some of these inequalities and providing comparisons with other areas and over time (where data are available).
A summary of key findings from the chapter can be found in the document below:
The chapter is structured into 10 main sections listed below.
Health and the environment – coming soon
- D. Buck and D. Maguire, “Inequalities in life expectancy: changes over time and implications for policy,” The King’s Fund, 2015.
- G. Dahlgren and M. Whitehead, “Policies and strategies to promote social equity in health,” Institute for Futures Studies, 1991.
- M. Marmot, “Fair Society, Healthy Lives,” The Marmot Review, 2010.
- Hackney Council, “Report of the Hackney a place for everyone consultation,” 2017 (forthcoming).