Historic and Geographic Patterns of Health Inequalities - Report of a roundtable

These range from the Elizabethan Poor Laws of the 16th century to the social welfare programmes developed in the aftermath of the Second World War and the health inequalities strategy put forward for England by the Labour Government at the start of the 21st century. [...] For example, the similarities between maps of COVID-19 mortality in England and Wales in 2020–21 and maps showing mortality rates in the 19th century could provide a useful tool to understand and intervene on the factors which have led to the entrenching of health inequalities across certain regions of the UK, in spite of historical policies attempting to address them. [...] Prior to the roundtable, the British Academy and the Academy of Medical Sciences undertook a short scoping review of existing literature on the geographic spread of historic health outcomes, in parallel with a series of supporting calls with a small number of researchers and other experts across a broad range of disciplines, to further develop and inform the approach to the research question. [...] The longer view highlights the importance of Elizabethan England’s universal care system and the Poor Law Act of 1601, which used progressive taxation to protect all subjects of the Crown from a range of vulnerabilities.7 The period since the Second World War, which saw the establishment of the NHS and significant restructuring of public health provision, is arguably most relevant for comparative. [...] A further shift which has occurred with the pandemic is a greater stress on the value of narrative accounts of the experience of COVID-19 (especially long COVID)38 and of the interaction of social inequalities that can drive health inequalities, particularly given the novelty of the virus.