Today the British Academy have published a new report suggesting nine ways that local authorities could reduce health inequalities. In this report nine authors propose one way in which the social causes of health inequalities can be tackled ranging from a 20mph speed limit for cars in residential areas to Professor Pickett’s proposal to implement a living wage.

As responsibility for public health has been devolved from the NHS to Local Government this provides an opportunity for local authorities to address public health in a more locally focused way. These changes are happening in the context of decrease government spending and large cuts to local authority budgets. If local authorities want to make the most efficient use of their limited resources then they should seek to tackle the socio-economic determinants of health directly.

One key determinant of health is income inequality. As Professor Pickett explains in Chapter 1, more equal societies have lower rates of obesity, infant mortality, drug addiction and longer life expectancy. The social gradient in health in the UK is particularly pronounced, if you live in the wealthiest areas of the UK you will live eight years longer than those living in the poorest area. New research has fleshed out the causal pathways behind this relationship showing that status competition increases stress and puts strain on family relationships.

Although local inequalities are important, what matters most is where people fit in national comparisons of social class. It is not inequality within a community that is most important but whether or not that community is deprived when compared against the rest of society. Yet, it is at a local level that this experience of inequality comes into being, principally through low levels of pay in local employers.

Professor Pickett’s piece highlights the importance of Local authorities leading the way in fighting these low pay levels by paying a living wage. Fairness Commissions across the country from Blackpool to Islington have concluded that local authorities can make their local areas fairer and more prosperous by paying a living wage and, as our Fair Pay in the Public Sector report laid out, there is already considerable movement in this direction.  As well as directly addressing the problem through paying their own employees a living wage, councils can encourage other local employers to pay a living wage and require it of those they have contractual relationships with. By raising low pay local authorities can ensure people make a decent living, counter income inequality and in doing so negate its damaging effect on the local population’s health.