Health inequalities in a nutshell

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  • Posted:Friday 20 August 2021

What are health inequalities?

Health inequalities are avoidable, unfair and systematic differences in health between different groups of people. Health inequalities are experienced between different groups of people and are often analysed across four main categories: socio-economic factors (for example, income); geography (for example, region); specific characteristics (for example, ethnicity or sexuality) and socially excluded groups (people who are asylum seekers or experiencing homeless). The effects of inequality are multiplied for those who have more than one type of disadvantage.

Five facts about different people's inequalities

How are they measured?

Health inequalities can be measured by differences in health outcomes in different groups of people. For example, in England life expectancy varies depending on where people live. People living in the most-deprived areas have a life expectancy nearly a decade shorter than the least-deprived areas (for example, life expectancy is 78 years in Manchester and 86 years in Westminster).

Life expectancy varies by almost a decade across England

The deprivation gap

The gap between people living in the most-deprived and the least-deprived areas is even wider in healthy life expectancy, which is a measure of how much time people spend in good health over the course of their lives. Those in the most deprived areas can expect to live 18 fewer healthy years than those in the least deprived areas. Currently only people in the three least-deprived deciles are likely to retire in good health, while people in the most-deprived centiles are expected to spend some of their working life in poor health.

Healthy life expectancy is more than 18 years lower for the the most deprived compared to the least deprived

Influence of a wide range of factors

Health inequalities are caused by a wide range of factors. The worse health outcomes occur when people have limited access to health care, experience poorer-quality care and practice more risky health-related behaviours (for example, smoking).

These factors are often influenced by wider determinants such as income, housing, environment, transport, education and work. Tackling health inequalities requires an understanding of the complex interaction between all these factors.

People in more deprived areas are more likely to take multiple health-related risks

The effect of Covid-19

Covid-19 has widened health inequalities in England by disproportionately affecting those already experiencing health inequalities, such as those in the most-deprived areas and people from ethnic minority backgrounds. As a result of the Covid-19 pandemic, life expectancy in England fell in 2020 for the first time since 2000. The ongoing effects of the pandemic on the economy are likely to have an impact on different parts of the population differently, and therefore widen health inequalities further.

Death rates from Covid-19 in the most-deprived areas were more than double rates in the least-deprived areas

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