However, the government must view this strategy as an opportunity to improve the lives of those with the worst health outcomes. The press statement does little to acknowledge the significant health inequalities that exist between different groups of women. Here are some examples of existing inequalities.
- Female life expectancy varies by almost eight years across England, ranging from 78.7 years in the most deprived areas to 86.4 in the least deprived areas. Women in the poorest areas also live more of their lives in poor health.
- Women in lower socioeconomic groups have a higher incidence of poor mental health and are more likely to have earlier onset of dementia compared to higher socioeconomic groups.
- On average 8 per cent fewer women from deprived areas attended their cervical screening compared to the least deprived, and there is a higher incidence of cervical cancer in deprived areas.
The data on diagnosis and care of women with breast cancer is also a good way of highlighting inequalities. Breast cancer is the most common type of cancer in the UK and the NHS offers regular breast cancer screening to women aged between 50 to 70 to prevent avoidable deaths from breast cancer by identifying breast cancer early, when it is more treatable, and survival is more likely.
Yet almost 10 per cent fewer women in the most deprived areas take their regular breast screening compared to those in the least deprived areas.
In 2019 Public Health England’s screening programme launched a strategy to address some of these inequalities. It outlined several steps to improve uptake, including working with relevant charities. It’s too early to see if this strategy has had any effect on closing the gap in breast cancer screening, but if the uptake in deprived groups does not improve significantly, we will continue to see higher mortality rates from breast cancer in these groups. Data from Cancer Research UK shows the differences in female mortality rates between the most deprived groups and the least deprived groups.
And deprivation isn’t the only driver of inequality – data shows that other groups of women experience challenges. For example, women from an ethnic minority background and women with learning difficulties are less likely to attend breast cancer screenings.
These examples, which are replicated across a wide range of conditions, show the importance of focusing on reducing health inequalities between different groups of women at the same time as improving the overall health of women.
As the press statement recognised, the starting point for the new strategy is to place women’s voices at the centre of their health and care. Yet, it is often the most disadvantaged groups that are the least likely to speak up and have their voices heard – the initial response rate to the call for evidence from some groups was so low that the deadline for submissions was extended by two weeks. The Women’s Health Strategy cannot risk leaving any women behind in its endeavours to improve the health of women overall – a good start would be to ensure that their voices are heard.