Tackling health inequalities will unleash communities and fuel our nation’s potential

By Joe Sarling, Strategic Director (GM Moving) | 13 March 2025 | TAGS: GM Moving, GM Moving in Action, Joe Sarling

The country faces profound health, economic, and inequality challenges that are stifling communities and constraining the nation’s potential. But there is a reason to be hopeful.

Where these challenges overlap lies the cross-cutting mission: movement and physical activity.

And the approach that joins dots across agendas to effect change within a place: whole-system thinking.

GM Moving made an evidence-based case for both in its spending review submission setting out clear asks and policy positions to help enable deeper and wider change.

Physical activity isn't a 'nice to have' - it is essential to growing the economy and an NHS fit for the future. Movement is the foundation of good health, wellbeing, and thriving, sustainable communities but it isn’t accessible to everyone and has been designed out of our lives.

Physical inactivity comes with a heavy national cost. Physical inactivity is associated with 1 in 6 deaths in the UK and is estimated to cost the UK £7.4 billion annually (including £0.9 billion to the NHS alone).

A record 4 million people are not participating in the labour market due to work-limiting health conditions, with 2.8 million citing long-term sickness or disability as their main reason for being out of the workforce.

There has also been a 64% increase in the last decade in the number of 16 to 64-year-olds with ill-health who are in work and a huge growth in health and disability-related welfare spending.

We can’t explore physical inactivity without exploring localised health inequalities. Latest Sport England data shows nearly 1 in 3 (28%) Greater Manchester residents are active for less than 30 minutes a week with an 11-percentage point difference in inactivity rates between our most active borough Stockport (24% inactive) and least active borough Oldham (35% inactive).

Wider Health Foundation analysis of Greater Manchester shows a 5.5-year life expectancy difference between Bolton South and Walkden (76.94 years) and Altrincham and Sale West (82.5 years). Obesity rates are highest among children in deprived areas with the gap continuing to grow.

A whole-system, place-based approach that builds on local strengths is the only way to solve this problem. Telling people to move doesn’t work, nor does blaming, shaming or judging people for their lifestyle choices, it’s about designing movement back into all our lives through systemic and cultural change.

Meaningful change is happening in GM through a place-based, collaborative approach that brings together people, communities, and organisations to co-create sustainable, long-term solutions. By supporting people and building on the unique strengths of each place, we are breaking down systemic barriers and creating opportunities for everyone to live healthy, active lives.

Central government can help create the right conditions for this approach to work in places if it thinks, acts, and invests in different ways. There are three key priorities that central government can harness if we’re to start to overcome these challenges:

1. Put sport and physical activity to work to power a prevention-first NHS
2. Embed movement at the heart of every school day
3. Design the places we live to encourage physical activity in everyday lives

If central government can think less programmatically and more cross-departmentally, it can create the right conditions for places to work in a whole-system way and reverse those localised inequalities. This will have a more long-term, sustained impact on people’s lives which, in turn, will have a positive impact on the economy. GM Moving’s spending review submission sets out a range of specific asks to realise this including:

1. Guaranteed prevention fund from the NHS (and accountability for improving population health) as part of a co-investment model with Sport England as part of a wider prevention fund tied to the new health duty of Mayoral Combined Authorities (MCAs);
2. Align financial incentives around the concept of a Healthy Neighbourhood exploring the role of an ‘earnback’ model with The Treasury;
3. A cross-departmental commitment, plan, and flexible funding for movement, physical activity and sport that is owned by all government departments, co-designed with MCAs with collective, mission-based leadership;
4. Devolved long term flexible funding from Sport England (at least 5 years) to allow local places to make informed and secure decisions.

The whole-system approach of GM is making a huge and demonstrable difference to people’s lives. Only through relentlessly connecting strategies, topics, and disciplines across the city-region could this be possible.

And a greater impact can be realised with a sustained long-term focus on physical activity alongside a shift in central government’s approach to creating the conditions for places to find their own solutions, harness their own strengths, and improve people’s lives.

Now is the time for that shift.