Inequalities in local funding cuts to environmental and regulatory service expenditure in England

Abstract

Abstract Background The financial crisis in 2008 has led to governments across Europe introducing austerity measures. England has experienced significant financial cuts to local authority (LA) services. Environmental and regulatory (ER) services provide key functions in public protection such as, Food Safety (FS) and Animal and Public Health Infectious Disease Control (APH), services which are key infectious disease resilience. Here we investigate inequalities in local funding cuts to ER services by socioeconomic deprivation, LA type, and urbanicity, and impact on key ER service indicators. Methods This ecological study uses longitudinal modelling techniques to analyse trends in ER expenditure since the introduction of austerity and the inequalities present. We use Generalised Estimating Equations to estimate the annual percent change of ER service expenditure, and FS and APH expenditure between 2009/10 and 2020/21 in relation to deprivation, LA type and population density. Quasi-Poisson regression is used to assess impact of cuts on ER service indicators. Results Areas of higher deprivation had the largest reduction in expenditure, with ER and FS and APH cuts of 2% and of 23% respectively, compared to a 1% and 8% reduction in the least deprived areas. The share of ER expenditure spent on FS and APH decreased by 13% in the most deprived authorities compared to 6% in the least deprived areas. London boroughs had the greatest reductions in FS and APH expenditure, decreasing by 10%. Both ER and FS and APH expenditure decreased with increasing population density. Preliminary analysis shows inequalities in food business hygiene ratings in addition to other key ER service indicators since the introduction of these cuts. Conclusions The unequal distribution of cuts shows the need for increased and equitable investment into these services to enable resilience to infectious disease threats, and to prevent widening of health inequalities. Key messages • This work provides strong evidence of inequalities in local funding cuts to ER services and highlights where investment should be focused, in order to protect environmental and public health. • This work introduces the impact of local funding cuts on a vital public health service and lays the foundation for future work into the unequal impact of cuts to these services on health outcomes.