The report, All Together Fairer: Health equity and the social determinants of health in Cheshire and Merseyside, is the latest in a series of ‘Marmot Reviews’. It is based on local evidence and makes ambitious recommendations to reduce health inequalities and create fairer societies for future generations in Cheshire and Merseyside. A set of local Marmot Beacon indicators, developed in partnership with hundreds of local stakeholders, will monitor these recommendations and actions and show the impact on the social determinants of health in Cheshire and Merseyside.

P.5 Prevention programmes and initiatives often focus on individual health behaviours, such as smoking, physical exercise, diets/nutrition, alcohol, and drugs. These factors affect health inequalities but do not address the drivers of these behaviours—the causes of the causes. The NHS has a role in supporting people but addressing the causes of the causes requires partnerships with wider systems, supporting people with good education and employment, fair pay and incomes, good quality homes and neighbourhoods. 

P.96 Alcohol and drugs - In England since 2012, avoidable mortality from alcohol and drug-related disorders has significantly increased for women and men living in the most deprived areas. Figure 4.39 shows the number of people dying from alcohol- and drug-related disorders has increased regardless of income. In men, the number of deaths in the most deprived areas has increased significantly more compared to deaths related to alcohol and drugs in men in the least deprived areas.