The Role of English Local Authorities in Addressing the Social Determinants of Health: A Public Health Perspective

This chapter examines the changing positioning of public health, moving between the National Health Service (NHS) and local government. The strategic movement, across both developed and developing countries, from concentrating health resources on communicable disease to a focus on non-communicable disease, is a response to modern epidemics of obesity, alcohol-related diseases, and the politics of health care. However, communicable diseases can still have major health, social, and economic impacts, as demonstrated by the potential pandemic caused by the rapid global of COVID-19 (Coronavirus). Clearly, austerity budgets have an effect on the health of particular segments of the population, with those people at the lower end of the social gradient being most affected by both quality of the environment and availability of health and social care. Public Health was incorporated into the NHS in 1974, and then, influenced by the Marmot Review (2010), it was returned to local authorities in 2013. Building on the 'science' of public health, public health professionals have been challenged to develop skills in the 'art' of public health that are required to influence policy change and systems leadership within their wider remit in local authorities.