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Over the rainbow: delivering on the promise of England's new public health system
  1. David Conrad
  1. Correspondence to David Conrad, Cheshire & Merseyside Centre, Public Health England, 5th Floor, Rail House, Lord Nelson Street, Liverpool L1 1JF, UK; david.conrad{at}

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The recent launch of Public Health England's ‘Longer Lives’ website (, which compares local authorities’ rates of premature death from the four most common causes of mortality, cast a media spotlight on the nation's stark health inequalities.1 Reducing these inequalities is a clear objective of England's new public health system2 which came into being in April this year. Part of the government's vision for this new system was that shifting the bulk of public health functions into local authorities would enable greater leverage to influence the wider determinants of health (the ‘causes of the causes’ of health problems) which underpin health inequalities.3 History suggests, however, that those working at the coalface of public health will need to meet some significant challenges if the failures of previous efforts to tackle health inequalities are not to be repeated.

The importance of addressing the wider determinants of health was firmly established in 1998 by the report of the ‘Independent Inquiry into …

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  • Competing interests The author is a consultant in public health employed by Public Health England.

  • Provenance and peer review Not commissioned; internally peer reviewed.