In the UK general election of May 2015, the main political parties pledged to develop economic growth and encourage a fairer society. In the snap general election of 2017, the main focus was on the withdrawal of the UK from the European Union (EU). The direct and indirect consequences of a hard or soft ‘Brexit’ will have significant consequences for individuals and the health of the community. From public health, economic, political and social justice perspectives, health inequalities are bad for individuals and bad for society. Concern about the escalating costs of the health and welfare systems in this diverse and ageing UK society should be addressed by considerations of upstream prevention strategies, mainly directed at lifestyle choices, and evidencebased approaches aimed at supporting people who are vulnerable to poor health and limitations in their quality of life.

The impact on the health of people in the UK following the passing of the National Health Services Act 1946, financed by general taxation, was a major breakthrough in public health that has laid the foundation for a healthy society in the UK. However, despite concerns about health and social class inequalities highlighted in the Black Report (1980), there was no political response to the Black recommendations to reduce social class inequalities by improving housing conditions and child benefit. In recent years, there have been attempts to deal with the health consequences of social inequalities and lifestyle choices; however, the most significant change in understanding these issues was clearly evidenced in the Marmot Report (2010). This analysis of extensive epidemiological data showed the strong links between the social gradient and the physical and mental health of people. This report highlighted the wide variations in social gradients in various countries and population health in those countries. Early childhood experiences, living conditions and employment all contribute to the quality of health and well-being across the life cycle.

It is widely understood that early childhood experiences and the development of social networks have a major impact on later-life health and well-being, which are mediated by the development of pro-social behaviour, resilience, coping skills and optimal cognitive functioning. These complex social behaviours require a healthy mind and body and the motivation to benefit and learn from a supportive environment.