Intended for healthcare professionals


What did the spending review do for population health?

BMJ 2021; 375 doi: (Published 08 November 2021) Cite this as: BMJ 2021;375:n2686
  1. Parth Patel, research fellow1,
  2. Lucinda Hiam, honorary research fellow2
  1. 1Institute for Public Policy Research, London, UK
  2. 2School of Geography and the Environment, University of Oxford, Oxford, UK
  1. Correspondence to: P Patel p.patel{at}

Not nearly enough

The Autumn Budget and Spending Review 2021 was perhaps the most important public policy moment of this parliament. The UK’s health and economy are recovering from the pandemic, but the rate, extent, and fairness of the recovery will be determined by the decisions made in this budget.

Life expectancy and gross domestic product (GDP) are useful indicators of the scale of the challenge the UK is facing. A new study of global mortality patterns estimates that life expectancy in the UK fell by around one year in 2020—the greatest fall since the second world war.1 The UK economy will be permanently two percentage points smaller because of the pandemic, according to the Office for Budget Responsibility.2 As with all aggregate measures, these figures conceal underlying inequalities—the most deprived groups in society have experienced the greatest loss of life and greatest increases in economic insecurity.3 How did the chancellor respond to these challenges, and what will it mean for population health in the UK in years to come?

Austerity gone but not forgotten

Public spending is …

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