By Dr Alice Walker, Public Health Consultant, Mayoral Regions Programme
English mayoral regional authorities can play a significant role in tackling poverty and mitigating its impacts on health outcomes. While many structural levers (like taxation and welfare) lie with national government, particularly in the context of the national devolution agenda, mayoral regions have growing influence over the social determinants of health. Opportunities include using devolved powers relating to regional economic growth, employment support, transport, skills, adult education, and planning to address the drivers of poverty and mitigate its impacts.
Mayors can also set poverty reduction as a core strategic priority within their region, coordinating across health, education, housing, and local economic development. This might include establishing regional strategies or convening cross-sector partnerships. For example, in 2024, the North East Combined Authority became the first region in England to launch a dedicated Child Poverty Reduction Unit, backed by an initial £500,000 investment. This unit is tasked with developing a tailored action plan across the seven local authority areas, and includes a focus on income maximisation, early child education and support, and providing support for parents to enter or re-enter the workforce.
At the Greater London Authority, the Universal Free School Meals programme has been introduced as a regional initiative to tackle child poverty and its associated health inequalities. This programme provides free, nutritious school meals to all primary school children in state-funded schools across London, irrespective of family income. The programme is being evaluated to capture impact on measures of family wellbeing and educational attainment.
The new health duty for Strategic Authorities, introduced in the English Devolution White Paper (December 2024), represents a significant shift in how public health and health inequalities can be addressed at the regional level. This duty is designed to empower mayoral regional authorities and larger unitary councils to take a proactive role in improving health outcomes and reducing health disparities within their jurisdictions. This has the potential to present new opportunities for regional efforts to address poverty through a Health in all Policies approach, which supports the integration of health considerations across sectors such as housing, education, and transport. By addressing the broader social determinants, or ‘building blocks’ of health, this approach aims to create environments that support the well-being of residents and reduce inequalities.
The Mayoral Regions Programme (MRP), hosted by the West Midlands Combined Authority and funded by the Health Foundation, has recently developed a Health in All Policies (HiAP) Toolkit for mayoral regional authorities. This has been designed to support mayoral regions to use their devolved powers and regional levers to improve health outcomes and reduce inequalities. It was developed through collaborative learning with colleagues across ten English mayoral regional authorities and aims to support a systematic approach to identification and prioritisation of HiAP opportunities, including those relating to poverty reduction. The MRP team is now working with colleagues from West Midlands, West Yorkshire, and North East Combined Authorities to apply the toolkit and provide tailored support with their HiAP strategy, implementation, monitoring, and evaluation. Learning from this process will be captured and shared with cross-regional partners via webinars and the dissemination of online resources.
To find out more about the programme and connect with mayoral regional colleagues working on poverty, health, and inequalities you can join the MRP’s online learning network by signing up to the Health Equity Network and requesting to join the MRP group.
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This article is featured in our 21 May newsletter.
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