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Need for Lived Experience at the centre of the response to Marmot Report

In late June 2021, the Institute of Health Equity published the Build Back Fairer in Greater Manchester: health equity and dignified lives report, outlining the practical recommendations to make Greater Manchester the U.K.’s first Marmot city-region. The context of which the report was published in, is the world-wide magnified inequality of COVID-19 related mortality and the long-standing impacts of social and economic containment, specifically noting Greater Manchester as experiencing highly unequal mortality. It also noted the poor socioeconomic circumstances of those most effected was 2.3 times more than the least deprived people in the city-region: significantly wider compared to the rest of England.


The report calls for health equity to be at the heart of governance, policy, and resource allocation with an aim to achieve permanent reductions in health inequality in the city. The recommended areas of focus include greenspaces, children and young people, housing, income, poverty, and debt – issues that have been priorities for grassroots community groups in Manchester for several years.


Speaking on the publication of the report, Michael Marmot discussed the importance of working in Greater Manchester, stating that there is a real appetite for significant change in the city, with an inspiring vision that can be supported with the practical frameworks outlined in the report. It was noted that prior to the pandemic, 8 out of 10 boroughs in Greater Manchester had lower life expectancies than the national average – particularly for women. The COVID–19 mortality rate was then 25% more than the rest of England, again more so for women.

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Andy Burnham, Greater Manchester Mayor reflected on the report findings and their detail of the reasons why the city-region has suffered not just a higher mortality rate but a greater exposure rate to the virus in general. These reasons include the number of people in front-line high-risk work, precarious employment with no sick pay and no housing arrangements which will protect their family from risk of infection.


There is a resounding message from the report and beyond that whilst it will be important that central government offer resource to Greater Manchester to achieve these practical steps, it will largely reply on the passion and determination for change from public service leaders in Manchester. The Social Rights Alliance would also argue that it will depend upon the authenticity of relationships between leaders and residents with lived experience of the inequalities laid out in the report. Manchester is in a prime position to create long-lasting social change across the county by not only following the practical framework in the Build Back Fairer report, but also by analysing the rights-violations happening at a hyper-local level. The alliance will continue to amplify the voices of residents in marginalised communities and lead the way in a human-rights based approach.

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