Health Inequalities

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" (The King's Fund, 2021).

Watch the video below by Shona Kelly from Sheffield Hallam University about health inequalities.

Health is generally worse in more deprived areas of the UK. A recent example includes the death rates from COVID-19, which were almost four times higher in people under the age of 65 years living in deprived areas compared to those living in wealthier areas (The Health Foundation, 2021).

Think about the social determinants of health we looked at in the previous section. Consider what factors may contribute to the higher death rates from COVID-19 in more deprived areas of the UK and share them on the Padlet below.

The Marmot Reviews

The Marmot Review (2010) was commissioned the UK Government to find out what could be done to reduce health inequalities. In the Review the following recommendations were made:

  1. Give every child the best start in life

  2. Enable all children, young people and adults to maximise their capabilities and have control of their lives

  3. Create fair employment and good work for all

  4. Ensure a healthy standard of living for all

  5. Create and develop healthy and sustainable places and communities

  6. Strengthen the role and impact of ill health prevention.

Since 2010 there has been further widening of health inequalities between different groups in the UK. The Marmot Review 10 Years On (2020) highlighted that improvements in life expectancy have halted and health inequalities have widened (see the video below).

"In the 10 years since the Marmot Review there have been momentous social, economic and political changes, which have, we argue, impacted on the health of the population and on health inequalities in England. Continued unchecked, they will have detrimental impacts in the future. Ten years of austerity policies and rolling back the state have resulted in widespread reductions in public spending and intervention in almost all areas; and, at the same time, social, economic and regional inequalities have deepened. As we show throughout this report, the most deprived areas and communities, particularly in the North of England, have experienced the greatest declines in funding in almost all social, economic and cultural domains, and poverty, poor health and socioeconomic inequalities have increased" (Marmot, 2020).

The Review builds upon the recommendations of the first Marmot Review (2010). It is recommended that there is increased spending on children's services, a development of the workforce working with children and young people, investment in poorer communities, better employment opportunities, and strengthened accountability for health inequalities. A link to the full Marmot Review 10 Years On is available in the Digging Deeper section.

The Future

Where do we go from here? To overcome health inequalities we need to work together, think creatively, and work closely with communities to improve the health and opportunities of our populations.

You are our future sport and health professionals. Think about the differences you can make the health of our nation. How can you address the complex causes for ill health in the individuals and communities you will be working with?

References

Marmot, M. (2010) Fair society, healthy lives: the Marmot Review: strategic review of health inequalities in England post-2010. https://www.parliament.uk/globalassets/documents/fair-society-healthy-lives-full-report.pdf

Marmot (2020) Health Equity in England: The Marmot Review 10 Years On. https://www.health.org.uk/publications/reports/the-marmot-review-10-years-on

The Health Foundation (2021) Unequal pandemic, fairer recovery: The COVID-19 impact inquiry report. https://www.health.org.uk/sites/default/files/upload/publications/2021/HEAJ8932-COVID-Impact-210705.pdf

The King's Fund (2021) Health Inequalities in a Nutshell. https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/health-inequalities