Dr. Sim will introduce Sir Michael Marmot.

Introduction to RSPH. Dr. Sim will include its vision, history and activities particularly focusing on the issues concerning the topic of this session, the Health Gap.

Place matters in terms of the public's health. Where we live can have a profound impact on our health and wellbeing, and within local communities. Malls and main streets are literally the shop window on a local community where many of us may undertake a spot of retail therapy, socialize or unwind. In the UK in 2015 we sought to recognize both the positive and negative contribution businesses on the nation’s High Streets makes to our health and wellbeing. Based on reviews of the evidence, plus expert and public opinion we attempted to identify those businesses which could be considered the most health promoting and those which evidence shows to be the most detrimental to public health. Alongside this we developed a “richter scale of health” which recognized the many dimensions of health and wellbeing across 4 different areas. We then procured data on the number of different types of businesses, for the 70 main retail areas across the UK and separately for 144 High Streets across London. Based on our methodology we arrived at a league table ranking the 70 largest towns and cities across the UK and 144 High Streets across the capital city. Our action research was two-fold. Firstly, it was to encourage Central Government to give planners and licensing authorities the powers they need to prevent the proliferation of unhealthy businesses; include health as a condition for licensing of all types of businesses and to introduce tighter controls on the numbers of premises license to sell alcohol in already saturated areas. Separately, it was to both nudge and shove businesses to adopt more health promoting practices, from providing customers with accessible information to support them in making healthy choices, and to introduce restrictions on practices which are harmful to health.

Public Health 3.0 (PH3) is a significant upgrade in public health practice to a modern vision that emphasizes cross-sectorial environmental, policy-and systems-level actions that directly affect the social determinants of health, and envisages local public health leaders as the Chief Health Strategist for their communities.

In developing strategies for tackling health inequalities we need to confront the social gradient in health not just the difference between the worst off and everybody else. There is clear evidence when we look across countries that national policies make a difference and that much can be done in cities, towns, and local areas. But policies and interventions must not be confined to the health care system; they need to address the conditions in which people are born, grow, live work, and age. The evidence shows that economic circumstances are important but are not the only drivers of health inequities. Tackling the health gap will take action, based on sound evidence, across the whole of society.