An article by Lucy Morrisey, Director in the Johnson & Johnson MedTech UK & Ireland Strategic Capabilities Team
Barely a day goes by without news of challenges to health care funding, individual stories of ill health, workforce challenges and huge pressures of demand on our health system. Yet at the same time, we hear about significant advances in treatment, technology and of course a huge commitment by those who work in health to improve the lives of others. A sustainable health system, which is equitable for all is a prized possession, yet I can never help having the old adage ringing in my ears ‘prevention is better than the cure’.
Public health has been thrust into the limelight, Covid brought to the general public the principles of population health and health protection, every day decisions were being made on national television which pitted decisions on the whole countries’ health against individual freedoms and behaviours.
A life-long fascination of public health, my academic and work choices led me to feeling at home in the public health community, where I met some of my most inspiring mentors and friends, and worked on some of the most challenging assignments. I was always drawn to contributing to unpicking complex problems, particular in the concept of the ‘social determinants of health’. The Inverse care law, first set out by Julian Tudor Hart in 1971 outlined that the “availability of good medical care tends to vary inversely with the need for it in the population served.
1The Marmot Review of 20102 stated the ‘conditions in which people are born, grow, live, work and age’, determine their health outcomes and life chances – and are commonly understood to follow a gradient according to socio-economic status. NHS England recognise these issues and have built their national programmes around addressing them, along with the economic role of the NHS and equitable access to care3.
Academics in the field of health economics are clear about the significant impact of health inequalities on the NHS - one research study from a York Health Economics, a highly respected authority in this area, set out that socio-economic inequality costs the NHS in England £4.8 billion a year4. There’s a global perspective too, numerous studies by WHO and OECD chart the impact of differing living conditions around the world with health of a country’s population.
It perhaps seems incongruent to be reading this from someone sat in a big Corporation, yet I see everyday the same issues playing out, be it in my teams, in the complex challenges we seek to help the NHS tackle, or personally, for example, have I walked the dog in a green space and noted its impact on my mindset for the day. It’s also an area Johnson & Johnson has ambitious goals to tackle over the coming years. As the world’s most broadly based healthcare company, we have a global responsibility in to support public health and equity challenges.
As with any huge systematic complex problem, the practical application of solutions is not only way beyond the scope of this short piece but also somewhat overwhelming, small steps in the right direction are needed. It’s encouraging to see progress everywhere; the work our partners in the NHS and HSE are doing to reduce barriers to access to care, the workforce policies I see my company implement around supporting employee health and wellbeing, and the action I (try!) to take each day to keep myself healthy.
As with everything, I am drawn to the conclusion that whatever issue in healthcare is being reviewed, they are all a matter of humanity above everything, and thus a collective challenge best addressed through collaboration and partnership between government bodies, healthcare delivery organisations and the wider industry partners that inhabit the healthcare system.
- Hart JT. The inverse care law. Lancet. 1971 Feb 27;1(7696):405-12. doi: 10.1016/s0140-6736(71)92410-x. PMID: 4100731.
- Marmot, M. Fair society, healthy lives : the Marmot Review : strategic review of health inequalities in England post-2010. (2010) ISBN 9780956487001
- https://www.england.nhs.uk/ Accessed 16th January 2023
- Asaria M, Doran T, Cookson R The costs of inequality: whole-population modelling study of lifetime inpatient hospital costs in the English National Health Service by level of neighbourhood deprivation, JECH 2016, doi:10.1136/jech-2016-207447