# English Devolution and Community Empowerment Act 2026, Section 45: Health improvement and health inequalities duty

Extent: E+W

(1) After section 107ZA of LDEDCA 2009 insert—
“Combined authorities: health
Health improvement and health inequalities duty
107ZB (1) When considering whether or how to exercise any of its functions, a combined authority must have regard to the need to—
(a) improve the health of persons in the combined authority’s area, and
(b) reduce health inequalities between persons living in the combined authority’s area.
(2) When considering whether or how to exercise any function, the mayor for the area of a combined authority must have regard to the considerations set out in subsection (1).
(3) Health inequalities “between persons” living in an area means health inequalities between persons, or persons of different descriptions, living in, or in different parts of, an area.
(4) “Health inequalities” means inequalities in respect of life expectancy or general state of health which are wholly or partly a result of differences in respect of general health determinants.
(5) “General health determinants” are—
(a) standards of housing, transport services or public safety,
(b) environmental factors, including air quality and access to green space and bodies of water,
(c) employment prospects, earning capacity and any other matters that affect levels of prosperity,
(d) the degree of ease or difficulty with which persons have access to public services,
(e) the use, or level of use, of tobacco, alcohol or other substances, and any other matters of personal behaviour or lifestyle, that are or may be harmful to health,
and any other matters that are determinants of life expectancy or the state of health of persons generally, other than genetic or biological factors.
(6) In subsection (1)(a), the reference to improving the health of persons includes a reference to mitigating any detriment to health which would otherwise be occasioned by the exercise of a combined authority’s function.
(7) In subsection (1)(b), the reference to reducing health inequalities includes a reference to mitigating any increase in health inequalities which would otherwise be occasioned by the exercise of a combined authority’s function.”
(2) After section 24 of LURA 2023 insert—
“Health improvement and health inequalities duty
24A (1) When considering whether or how to exercise any of its functions, a CCA must have regard to the need to—
(a) improve the health of persons in the CCA’s area, and
(b) reduce health inequalities between persons living in the CCA’s area.
(2) When considering whether or how to exercise any function, the mayor for the area of a CCA must have regard to the considerations set out in subsection (1).
(3) Health inequalities “between persons” living in an area means health inequalities between persons, or persons of different descriptions, living in, or in different parts of, an area.
(4) “Health inequalities” means inequalities in respect of life expectancy or general state of health which are wholly or partly a result of differences in respect of general health determinants.
(5) “General health determinants” are—
(a) standards of housing, transport services or public safety,
(b) environmental factors, including air quality and access to green space and bodies of water,
(c) employment prospects, earning capacity and any other matters that affect levels of prosperity,
(d) the degree of ease or difficulty with which persons have access to public services,
(e) the use, or level of use, of tobacco, alcohol or other substances, and any other matters of personal behaviour or lifestyle, that are or may be harmful to health,
and any other matters that are determinants of life expectancy or the state of health of persons generally, other than genetic or biological factors.
(6) In subsection (1)(a) above, the reference to improving the health of persons includes a reference to mitigating any detriment to health which would otherwise be occasioned by the exercise of a CCA’s function.
(7) In subsection (1)(b) above, the reference to reducing health inequalities includes a reference to mitigating any increase in health inequalities which would otherwise be occasioned by the exercise of a CCA’s function.”
(3) In section 309(F)(5) of GLAA 1999 (health inequalities between persons living in Greater London) after paragraph (a), insert—
“(aa) environmental factors, including air quality and access to green space and bodies of water,”.

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Source: https://www.legislation.gov.uk/ukpga/2026/23/section/45 (the official version)
Page: https://openlegislation.uk/english-devolution-and-community-empowerment-act-2026/section-45
Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives.