County Spotlight - Public Health

This County Spotlight highlights how our member authorities have led public health efforts before, during, and after the Covid‑19 pandemic.

Featuring 16 case studies, it outlines how counties’ local knowledge, scale, and partnership working have been instrumental in protecting residents, supporting national vaccination efforts, and embedding long‑term health improvement strategies.

It also reflects on the evolving policy landscape, rising health inequalities, and the need for county authorities to remain central to public health delivery as new national structures emerge.

Released several years after public health was devolved to councils, this report demonstrates that public health functions are most effective when delivered locally, enabling councils to address wider determinants of health, reduce inequalities, and build healthier communities for the future.

Data outlined in the report shows that in county areas:

• 57.1m vaccine doses delivered (49% of England’s total).  
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• Smoking prevalence reduced from 18.3% to 11.5% (2012–2020).  
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• New STI diagnoses fell from 570.1 to 359.5 per 100,000.  
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• Life expectancy in counties increased slightly for men (79.8→80.1) and women (83.6→83.8).  
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• County public health spend averages 7% of budgets, but government funding is 25% below national average.

‍Recommendations to government include:

• Maintain public health functions within local government.

• Strengthen integration with ICSs and new national public health bodies.
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• Invest in prevention, mental health, and wider determinants of health.

For councils:

• Continue data-driven, preventative approaches.
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• Support hard‑to‑reach communities through mobile and community‑based services.
   
• Embed public health across all council functions, including children’s services and housing.