What does health inequalities mean and why focus on it?
October 10, 2023
You may see us in other areas of the Internet referencing the NHS Long Term Plan and the Core20plus5 from time to time, which is NHS England’s approaches to tackling health inequalities on both a national and local level. But, what exactly does health inequalities mean to us and for the UK?
Health inequalities affect the health and wellbeing of millions of people in the UK – they are unfair and avoidable differences in health outcomes between groups of people or particular populations. For example, how long we live, the type of preventable diseases that are diagnosed and what age we get them. These inequalities are a major public health challenge, and it is why our mission here at One Wirral CIC is finding ways to improve health and wellbeing within Wirral.
What causes health inequalities?
Like with many things to do with health, health inequalities are a result of a lot of complex factors such as geography, socio-economic status, gender and health literacy, which can all impact access to services.
Limited access to services, resources and opportunities can usually be found amongst people who live in deprived areas, where you are likely to find poorer living and working conditions, lower incomes, less education and support compared to those in slightly wealthier communities.
According to insights from NHS GP data, people that have lower incomes are more likely to be overweight, exercise less, experience mental illness and smoke. These can then result in higher risks of developing diseases such as cancer or diabetes.
Unfortunately, the impact of health inequalities is significant and widespread across the UK. If we look at some national statistics from the King’s Fund, there is over a nine year gap in life expectancy and over 18 years in health life expectancy between the most and least deprived areas in England – made worse since the Covid-19 pandemic.
How do health inequalities affect the NHS?
Health inequalities have a significant economic and social costs. The Marmot Review published in 2010, estimated that health inequalities cost the UK economy £31-33 billion per year in lost productivity, £20-32 billion per year in lost taxes and higher welfare payments, and £5.5 billion per year in additional NHS healthcare costs. Since then, in many places, levels of deprivation and exclusion have been reported to have got worse.
With more people seeking healthcare support, there is an increase in demand and pressure on the NHS and its staff. Referring to some information from NHS England, people who experience health inequalities are more likely to have more, and more complex health needs, and to need health care at later stages of their conditions.
Therefore, it is more likely that the quality and access to care will be impacted – increasing the number of barriers to accessing the necessary health services, and having even more knock-on effects for people who may already struggle in engaging with healthcare services.
Health inequalities within Merseyside
Digging into some more data, research shows that health inequalities are not only obvious between different areas, but within them as well. For example, there is a gap of 11.1 years in life expectancy for men and 8.9 years for women between the most and least poor areas in Liverpool.
With some of the highest levels of deprivation in England, four of our local authorities (Liverpool, Knowsley, St Helens, and Wirral) were rated among the 20% most deprived boroughs. As well as that, Cheshire and Merseyside has been extremely affected by the COVID-19 pandemic, with higher rates of infection, hospitalisation, and loss of life than the national average.
Health inequalities in Wirral have big impacts for the health and wellbeing of our residents, as well as for the demand and cost of health and social care services. For example, 2019’s local authority health profile for Wirral, showed that our area experiences higher numbers of emergency hospital admissions for conditions that are considered preventable or manageable in primary care. Wirral also has higher rates of hospital admissions for self-harm, alcohol-related harm, and drug misuse than the national average, which is a sad and alarming statistic to read.
However, working together with other organisations and sectors has the potential to reduce health inequalities and improve population health. Wirral is part of the Cheshire & Merseyside Health and Care Partnership, which is one of the 42 integrated care systems (ICSs) in England that have a focus on bringing together local organisations to redesign care and improve overall health.
What is One Wirral doing to address this?
Wirral is also part of the Healthy Wirral programme, which is a place-based partnership that brings together the local authority, the NHS, the voluntary and community sector, and local residents to develop a shared vision and plan for improving health and wellbeing in Wirral. We do this with delivering our very own projects and services, and with the support of other community organisations. A few examples of how we do this include:
- Engaging with local communities and key members to help find solutions that are tailored to their needs, preferences, and resources
- Promoting healthy lifestyles and behaviours through campaigns, programmes, and interventions via our social media pages as well as through training sessions for healthcare professionals
- Supporting people in our community with specific health problems through physical activity [link to pre-hab page], arts and culture, learning and skills, and support groups
- Using data and first-hand information to develop a population health management approach that helps not only monitor our impact, but find risks of different groups and individuals across Wirral
Health inequalities and diseases have huge consequences for individuals, communities, and society as a whole. For individuals, inequalities and diseases can reduce quality of life, limit opportunities, increase suffering and reducing life length.
For communities, it can create social problems, such as crime, violence, and isolation. Looking at society as a whole, health inequalities and diseases can also impact the economy, because of the costs of health and social care, lost productivity, and reduced tax income.
So, reducing health inequalities is not only a moral duty for the NHS, but also vital for it to thrive long-term and improve its efficiency. It requires constant action across multiple levels and sectors, as well as collaboration and coordination between different partners and community members.
It also needs a shift in mindset and culture from focusing on treating illness, to preventing it, from delivering services to enabling people, and from working alone, to working together. If we can all take this approach, we can create a fairer society where everyone has the opportunity to live a long and healthy life.