Aufgabe HT 3 - Sozialstaat · Abitur NRW Sozialwissenschaften GK · Haupttermin · bilingual Englisch 2021

Michael Marmot

Covid exposed massive inequality. Britain cannot return to 'normal'

[...]

Inequalities in health, and in the social conditions that lead to ill health, have been revealed

and amplified by the pandemic and the response to it. Now, with vaccines coming onstream,

there is talk of Britain getting back to “normal”. But the “normal” that existed in February

2020 is not acceptable. The Covid-19 pandemic must be taken as an opportunity to build a

5 fairer society.

A new report that my colleagues and I at UCL 1 have published today uses evidence to suggest

how we go about doing this.

In February 2020, just one month before the UK entered a national lockdown, we published

a review of what had happened to Britain’s health and health inequalities in the 10 years

10 since 2010. The picture was bleak: stalling life expectancy and rising inequalities between

socioeconomic groups and regions. Most remarkable was the bucking of a long-term trend

of health improving year on year: a woman living in the most deprived area in north-east

England, or other areas outside London, had less chance of living a long and healthy life in

2019 than she would have had 10 years ago. We made a series of recommendations, addressing

15 the social determinants of health, for how things could and should improve.

Then, Covid-19 changed the world dramatically. But in England the changes have been entirely

consistent with its state before the pandemic hit. England’s comparatively poor management

of the pandemic was of a piece with its health improvement falling behind that of other rich

countries in the previous decade.

20 There are four possible explanations: the quality of governance and political culture, which

did not prioritise the conditions for good health; continuing increases in economic and social

inequalities, including a rise in poverty among families with children; a policy of austerity

and consequent cuts to funding of public services that were sharply regressive; and a poor

state of the nation’s health.

25 Addressing all four of these is at the heart of what needs to be done to bring about change.

A striking feature of the pandemic is the way the risk of fatal Covid-19 is distributed unevenly

across the country: the more deprived the area, the higher the mortality rate. This looks rather

similar to the picture for all causes of death. Another is the high mortality rate of members of

black, Asian and minority ethnic groups. Much of this excess risk can be attributed to living

30 in more deprived areas, working in high-risk occupations, living in overcrowded conditions

and, in the case of Bangladeshi and Pakistani groups, a greater prevalence of relevant pre-

existing conditions.

[...]

Our new report is called Build Back Fairer. One objection to our proposals is about money.

35 Reversing the cuts to children’s centres, to per-student funding in schools, to local government,

to adult social care, to the health service, will take public spending. So too will paying care

workers a living wage and having more generous safety nets that do not consign families to

dire poverty. At a time of huge national debt, can the country afford it?

Britain has tried the austerity experiment. It did not work, if health and wellbeing are the

40 markers of success. Phrases such as “maxing out the nation’s credit card” are neither helpful

nor based on sound economics. At a time of zero interest rates, with a tax rate that is at the

low end among European countries, and with control of its own currency, a nation can borrow

and it can tax for the purpose of building a fairer society – it can even print money (quantitative

easing).

45 We should not be asking if we can afford for our children’s wellbeing to rank better than

27th out of 38 rich countries, or to pay for free school meals during holidays so that eligible

children do not go to bed hungry. Social justice requires it.

[...]

To emerge from this pandemic in a healthier state, we need commitment at two levels. First,

50 to social justice and putting equity of health and wellbeing at the heart of all policymaking.

Cutting spending in a regressive way – the poorer the area, the steeper the cut – is unfair and

is likely to make health inequalities worse.

The pandemic has shown that when the health of the public is severely threatened, other

considerations become secondary. Enduring social and economic inequalities mean that the

55 health of the public was threatened before the pandemic and during it, and will be after it. [...]

The second level is to take the specific actions to create healthier lives for all throughout life:

from reducing levels of child poverty to 10%, to ensuring wages (or benefits for those who

cannot work) are sufficient to lead a healthy life, to creating the conditions for older people

to lead meaningful lives.

60 The evidence is clear. There is so much that can be done to improve the quality of people’s

lives. Inequality in health is a solvable problem. It is in all our interests to build back fairer.

1 University College London

About the author: Michael Marmot, born 1945, is professor of epidemiology at University College London, director of the UCL Institute of Health Equity and past president of the World Medical Association.

Materialgrundlage: Michael Marmot: Covid exposed massive inequality. Britain cannot return to 'normal'. In: The Guardian (online), 15. Dezember 2020 (gekürzt). URL: https://www.theguardian.com/commentisfree/2020/dec/15/health-inequalities-covid-ucl-government-policymaking (Zugriff am 14.01.2021)

2.

Outline the goals of the German welfare state and two principles of social security (e. g. the insurance principle). (24 Punkte)