Inequalities in local funding cuts to environmental and regulatory service expenditure in England from 2009 to 2020

Background Local authorities have been subject to substantial reductions in funding, placing strain on local services. Environmental and Regulatory (ER) services provide essential functions including infectious disease prevention and control via Food Safety and Animal and Public Health Infectious Disease Control services (APHIDC). This study investigates inequalities in local funding cuts to these services.

Methods We used a generalised estimating equation model to estimate the annual percent change of ER service expenditure between 2009/10 and 2020/21 in addition to Food Safety and APHIDC expenditure change overall, and as a share of total ER expenditure. Models analysed trends by deprivation level, local authority structure and population density.

Results Areas of higher deprivation had the largest reduction in expenditure, with ER and Food Safety and APHIDC 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 Food Safety and APHIDC decreased by 13% in the most deprived authorities compared to 6% in the least deprived areas. Environmental and Regulatory services saw the largest cuts in unitary authorities, declining by 2%. London boroughs had the greatest reductions in Food Safety and APHIDC expenditure, decreasing by 10%. Both ER and Food Safety and APHIDC expenditure decreased with increasing population density.

Conclusion The unequal distribution of cuts shows the need for increased and equitable investment into these services to enable resilience to emerging infectious disease threats, and to prevent widening of health inequalities.