Introduction

There are striking similarities in patterns of inequality in education and in health. In education, as in health, the poorest outcomes accrue systematically to the most disadvantaged (DfE, 2016). Moreover, just as health outcomes are not simply a product of access to, or the practices of, health-care providers, educational outcomes are not simply products of access to particular schools or of schools’ internal practices – important though these are. In both fields, to start to understand why this is so requires an explanatory framework that considers the ‘social determinants’ that shape these outcomes (see, for instance, the ‘rainbow model’ of the social determinants of health outlined in the Preface). This, as Sir Michael Marmot has argued, requires a focus on ‘the causes’ and ‘the causes of the causes’ of poor outcomes; as he explains in relation to health:

Much the same could be said of inequalities in education, which, as will be explored later in this chapter, are also known to be affected by where children live, family income and local employment prospects, among other factors.

Given these strong similarities, this chapter will argue that a central part of efforts to address educational inequalities must be for education, as a field, to think and act more comprehensively in ways that parallel thinking about the social determinants of health. Taking England as an illustrative case, the chapter will outline broad patterns of educational inequality and recent policy responses to these, arguing that there is a need for greater understanding of, and engagement with, the underlying causes of educational inequalities. It will then argue that it is possible for schools to lead the development of innovative responses to educational inequalities at a local level by engaging in children's family and community contexts alongside internal school reforms – with this highlighting overlaps between educational and health inequalities and the responses needed to address these. To illustrate this, an empirical example of an initiative to develop children's speech, language and communication skills is reported.