Health in all policies: Investing in our Nation’s greatest asset
Health is no longer just a matter for the NHS. From economic inactivity to life chances, the health of our nation is shaping our prosperity, our productivity and our potential. But those opportunities are not evenly shared. Health inequalities in this country are stark: a man in one of the most deprived areas can expect to live almost two decades fewer years in good health than one in the wealthiest. These inequalities are widening, leaving communities locked out of opportunity and draining our economic potential. Rising rates of chronic illness and stalled life expectancy now place unprecedented strain not only on our health service but also on our workforce and economy.
Tackling this challenge provides policy makers with a huge opportunity. By embedding health considerations into housing, transport, education and economic policy, we can extend healthy lives, reduce pressure on public services, and unlock the growth and resilience our country urgently needs. If we are serious about restoring growth, strengthening communities and ensuring opportunity for all, then narrowing health inequalities must become central to government policy. This is the essence of a Health in All Policies (HiAP) approach: recognising that every department - from housing to transport, education to energy - has a part to play in shaping the conditions for healthy lives.
As a public health doctor, I welcome the government’s commitment to prevention in the NHS Ten Year Plan. The rollout of smoke-free generation legislation, record investment in active travel infrastructure, and bold moves on obesity prevention all demonstrate a recognition that protecting health requires action far beyond the Department of Health and Social Care.
But the evidence is clear: siloed interventions are not enough. To turn the tide on entrenched inequalities and stalled life expectancy, we need a systematic approach across Whitehall that makes reducing health gaps a shared priority.
The evidence for action
The rationale for HiAP is compelling. Studies consistently show that the wider determinants - income, housing, education, employment, transport and environment - are the major drivers of health. The Health Foundation has highlighted that improving these conditions could yield long-term gains in productivity, social cohesion and reduced demand on public services.
In England, the Sure Start programme reduced hospital admissions among primary school children by 18%, with the largest benefits in our poorest communities - helping to narrow health gaps at the earliest stage of life. The Treasury’s own Green Book guidance recognises that every £1 invested in smoking cessation saves the NHS around £10 in future treatment costs. Public Health England has shown that investment in active travel delivers a return of £5–£6 for every £1 spent, through improved health, cleaner air and less congestion. And narrowing the gap in employment rates between people with long-term conditions and the general population could boost GDP by billions each year.
These examples underline the case: prevention is not a cost but an investment in both fairness and prosperity.
Building the case for Health in All Policies in the UK
So what should we do here? First, we must strengthen the tools that embed health considerations into decision-making. Health Impact Assessments (HIAs) offer a flexible and evidence-based mechanism to assess how policies affect health and inequalities before they are implemented. Local authorities in London have pioneered their use in planning, but coverage remains patchy. Mandating HIAs for major national policies, supported by a central unit with expertise and resources, would ensure consistency and maximise impact.
Second, we should invest in the capacity and skills to make HiAP a reality. This means training civil servants across departments in the use of health data, equity analysis and stakeholder engagement, and creating a competency framework to professionalise HIA practice. In Wales, the dedicated HIA Support Unit has been vital in sustaining momentum – a model we should replicate nationally.
Third, government must commit to long-term funding for prevention and cross-sector collaboration. Too often, innovative programmes falter when short-term budgets run out. Yet the UK’s own record proves the value of sustained investment. From Sure Start’s measurable impact on child health, to the smoking ban that has saved thousands of lives and billions in health costs, to investments in cycling and walking that pay back several times over, the message is clear: prevention pays. And when prevention is targeted to reduce inequalities, it delivers a double dividend: fairer outcomes and stronger economic performance.
Finally, we must embed accountability. Just as the Office for Budget Responsibility scrutinises fiscal policy, we could establish an independent body to monitor the health and inequality impact of government action. This would help ensure health outcomes are placed on equal footing with GDP or employment rates as measures of national progress.
Why this matters now
The UK faces profound challenges: an ageing population, rising chronic disease, economic headwinds and the climate emergency. Each demands a long-term, whole-of-government response. A HiAP approach offers a framework to bring coherence, align incentives and ensure that the policies we implement today do not deepen the health inequalities of tomorrow.
It is also a matter of fairness. No child’s future should be determined by the postcode into which they are born. By embedding health into education, housing and employment policy, we can break the link between deprivation and poor outcomes. That is the surest route to levelling up and to building a society where prosperity is shared more evenly.
The government has already shown it is willing to be bold on public health - from tackling smoking to addressing obesity. The next step is to make health a shared responsibility across every department, not an afterthought. By adopting a Health in All Policies approach, underpinned by mandatory health impact assessments, dedicated resources, and strong accountability, we can unlock the full potential of our nation’s greatest asset: the health of its people.
Dr Beccy Cooper is the Labour MP for Worthing West.
