Why invest in public health?
Local authority public health interventions funded by the grant provide excellent value for money. Research shows that each additional year of good health achieved in the population by public health interventions costs £3,800, measured using Quality Adjusted Life Years (QALYs). This is three to four times lower than the cost resulting from NHS interventions of £13,500 (per additional year of good health).
A review by the University of Cambridge, commissioned by the Health Foundation, has found a considerable evidence base demonstrating the effectiveness and cost effectiveness of public health and preventative interventions. Not all public health interventions are equally effective or cost effective, and their impact on health inequalities can differ. Public health teams need to determine the combinations of services to commission and deliver to best improve health and reduce inequalities in their local areas.
Which local areas have seen the biggest reduction in the grant?
Poor health is strongly associated with living in socioeconomic deprivation. There is a 20-year gap in the number of years a girl born in the most deprived 10% of areas can expect to live in good health, compared with a girl born in the least deprived 10% of local areas. These underlying health inequalities contributed to the COVID-19 mortality rate for those younger than 65 years being nearly four times higher in the most deprived areas than for those in the least deprived.
However, cuts to the grant have been greater in more deprived areas. Figure 4 compares the real-terms per person cut in public health grant allocations (accounting for additional drug and alcohol treatment and stop smoking services funding) between 2015/16 and 2024/25 to the deprivation score in each local authority. It shows that per person reductions in the public health grant tend to be largest in more deprived areas. In Blackpool, ranked as the most deprived upper tier local authority in England, the per person cut to the grant has been one of the largest – at £27 per person.
