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Public Health report addresses health inequalities

Monday, 30 September 2019

The Isle of Man Director of Public Health Dr Henrietta Ewart has published her 2019 Annual Report: The Isle of Man: An Equal Society?

Dr Ewart’s independent report asks how far inequalities in society influence the health and wellbeing of the population, and how government can act to improve health outcomes for all. It points out that tackling inequality underpins the Programme for Government and is essential if we are to help people live longer, healthier lives.

The report draws on evidence from around the UK, where differences in health and wellbeing are linked to differences in the socio-economic status of individuals and communities, with a clear association between deprivation, ill health and mortality rates.

However, the report concludes that in order to understand the situation Island-wide, more data is needed on the nature of inequalities and where they exist, and that a comprehensive dataset is needed so that government can set priorities for action.

Dr Ewart said:

‘Health isn’t distributed equally throughout the population, there is overwhelming evidence from multiple countries that health has a social gradient – the more affluent and well-off you are, the better your health outcomes are likely to be.’

‘This year’s report is a plea for us to agree what indicators we need to help us understand the situation, and then agree that we will go out and collect the data and routinely publish these, so we can all have a better understanding of where we are at the moment.’

Dr Ewart added:

‘Reducing inequalities in health benefits society as well as individuals and families. It brings economic benefits through reducing economic losses due to illness – productivity losses, reduced tax revenue, higher welfare payments and increased treatment costs to the NHS.’

The report makes clear that reducing health inequalities is not just about targeting healthcare services or health improvement initiatives in areas where there is deprivation or poverty. Instead, it argues that action needs to be taken across government to address social inequalities, which affect an individual’s ability to make healthy lifestyle choices. Unemployment, education and housing are listed among the wider ‘determinants of health’.

On the positive said, Dr Ewart suggests that the Isle of Man has ‘an extraordinary opportunity’ as a small island nation to address inequalities through co-ordinated action driven by government policy. She acknowledges that there is a lot of work already going on in this area, but there are also gaps where more could be done.

The 2019 report ends with an update from the Director of Public Health on issues raised in her previous two annual reports. The report can be viewed online and printed copies are available from the Welcome Centre and in libraries across the Island.

The full report can be viewed at

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