Health inequalities are avoidable differences in health across our populations. You can suffer health inequalities because of where you were born or live, your ethnicity, or even because of your job.
Sadly, they are persistent within our communities and their causes are often beyond our control, stemming from multiple complex causes that may require systemic change.
Health inequalities lead to people from different parts of the country, or different ethnic groups, experiencing profound differences in life expectancy, as well as different health outcomes from the same illnesses.
As well as the personal impact, health inequalities strain health services and reduce economic productivity.
We are committed to achieving the best possible health protection outcomes for everyone across England. This commitment is integral to everything we do and a key part of our Health Equity for Health Security Strategy.
For the first time, we are bringing together wide-ranging new data through our Health Inequalities in Health Protection report, which provides a high-level summary of the current state of health inequalities in England caused by infectious diseases, as well as environmental health hazards.
This report is just the start. By highlighting these findings, we aim to enable policy makers, health care professionals and others to understand who is most affected, and where, so that we can increase action to support communities to live in better health.
The social, physical, mental and economic cost to our communities
Emergency, hospital admission rates for infectious diseases are nearly twice as high in the 20% most deprived areas compared to the least deprived. Individuals living in the 20% most deprived areas of the country are over 7 times more likely to have an emergency admission to hospital for tuberculosis and 6 times more likely for measles, compared to those in the least deprived areas.
Those living in the North West experience emergency hospital admission rates for infectious disease that are around 30% higher than the national average, and over 50% higher than those in the South East.
Impacts from environmental hazards are also linked to deprivation. Areas with higher levels of poverty often have greater air pollution, and people living in these places are more likely to face the effects of adverse weather, due in part to inefficient home insulation and fuel poverty.
The report highlights the way in which these inequalities are amplified for people within inclusion health groups, such as people seeking asylum, people in prison, people experiencing homelessness and people who inject drugs. They are often disproportionately impacted by a range of infectious diseases. For example, it is estimated that over 80% of people in England living with chronic hepatitis C have an injecting drug history.
In addition to the social, physical and mental health costs to our communities, health inequalities also create a significant economic burden. It was estimated that inequalities in emergency infectious disease hospital admissions cost the NHS between £970 million and £1.5 billion in 2022/23.
Reducing health inequalities in health protection
We aim to help protect the public’s health and keep all of our communities safe and ensuring equitable health outcomes will help save lives and protect livelihoods.
We are building our understanding of the communities that experience these inequalities and improving our insight on where best to focus our efforts, and can provide our partners with tailored advice when required, so they can support everyone in the most effective way possible. This can involve working together to improve vaccine uptake, progressing the World Health Organization elimination goals on bloodborne viruses and HIV, managing outbreaks and incidents, or protecting communities from heat waves and flooding. We also work across government in partnership to address the wider determinants of health. Our data and analysis of the evidence, such as in this report, will help us to achieve this.
Through persistent and dedicated effort across all health organisations, national and local government and academia we aim to make a real difference. So that no matter where you live, your ethnicity or your background, we will all have the opportunity for more equitable health outcomes.