LC462 - UK Health Inequalities: Government Approaches & Success

This essay provides a comprehensive analysis of health inequalities in the UK, focusing on the social, economic, and political factors that contribute to these disparities. It examines the role of education, income, and occupation in shaping health outcomes, highlighting the significant differences in life expectancy and health conditions between the most and least deprived areas. The essay also evaluates the government's strategies for addressing health inequalities, including initiatives by Public Health England (PHE), the Homeless Reduction Act, and the Social Value Act. Furthermore, it discusses the influence of professional practices and political factors, such as the role of the Department of Health and the NHS, in promoting social inclusion and reducing health disparities. The essay concludes by emphasizing the need for continued efforts to ensure equal opportunities and improve the health and well-being of all individuals in the UK.

Contemporary Debates 1
Contemporary Debates

Contemporary Debates 2
Table of Contents
Essay.................................................................................................................................3
References.........................................................................................................................8

Contemporary Debates 3
Essay
Understanding of the health inequality in UK
Inequality in health refers to a condition where the health of one group of people in the
country is much worse than the other group. In UK, there are significant health
inequalities which are prevailing across the country. The health differences in UK are
caused due to economic and social inequalities in the environment under which
individuals are born, work, live, and age. The social gradient for inequality in health is
the differences between the social positions of the individuals. The social position refers
to different aspects which include education, unemployment, low income, and gender.
Significant concern is expressed by doctors in UK in context of social equality and
poverty and their negative effects on the physical and mental health as well as life
expectancy of the individuals in UK (Bma, 2016). The differences in social position of
the individuals become the major reasons due to which inequalities are created in the
health. Education plays a significant role in creating health inequalities. The section of
people which posses higher level of education are observed to have better health
outcomes in comparison to those with low level of education. This is because an
educated person has more literacy towards health which means that an education
individual will have the appropriate understanding, knowledge, confidence, and skills to
evaluate, access, and use the information related to health and social care and
services. Education is connected with health literacy and health literacy is connected
with health outcomes and the use of services. Limited education directly leads to the
behavior of unhealthy lifestyle such as lack of physical activity, smoking, and poor diet
intake. It is also observed that people who have limited education uses more
emergency services and are unable to manage positive healthy living in the long term
which also leads to incurring of high costs of healthcare. In UK, 42% of adults who are
of working-age are not able to understand the use of information related to everyday
health. Also, 61% of this population is not able to comprehend the information when
there is a requirement of numerical skills (Public health England, 2015).
Occupation and income are the social gradients which are directly related to poverty.
Unemployment and low income leads to poverty. People repeatedly move between

Contemporary Debates 4
work and employment in UK which has become an epidemic problem. Due to recession,
it has increase to more than 60% since 2006. In addition to this, low payment to workers
is also a factor which leads to poverty. As per the report of ONS (Office for National
Statistics) 2014, one out of every five employees is paid low in UK. The low paid
employees are women aged between 16 to 24, temporary and part-time employees,
employees working in low-skilled occupations, and also the employees working in retail,
care, and hospitality sector. Unemployment and low payment impacts the health on
individuals in child, adolescence, and later stage as well. In UK, the weight of the babies
born in poor areas is 200 grams less than the babies who are born in rich areas (Lee et
al., 2013). Poverty results in post-natal depression in women which leads to low
breastfeeding rate which impacts the mental and physical health of the babies in
negative manner. Also, the likeliness to suffer from chronic diseases like diabetes,
asthma, obesity, malnutrition, and tooth decay in higher in the children living in most
deprived areas as compared to least deprived areas. As per the report of NHS, 12.5%
of the children taking admission in the schools in deprived areas are obese while that of
least deprived areas is 5.5% only. In children of six years of age, the rate of obese
children was 26% in deprived areas as compared to 11.7% in least deprived areas in
UK (Koshy and Brabin, 2012). Due to unemployment and low income, the parents in
deprived areas are unable to provide enriching environment for children which
negatively impact the emotional and social development of children and hinder their
mental well-being. Likewise, the health conditions such as lung cancer, stomach cancer,
and respiratory diseases are also high in deprived population.
The long-term health conditions such as arthritis, diabetes, hypertension, and
obstructive pulmonary disease are commonly observed in adults belonging to lower
socio-economic groups. For instance, 2/5th of the adults aged between 45 to 64 and
income less than the average income suffer from long-term illness twice than the adults
with above average incomes of same age. The low income and unemployment also
causes stress in adults which disturbs their mental wellbeing. According to the report of
Mental Health Foundation, three out of every four people with low income experiences
problems related to mental health (Berry, Clarke, Jenkins, and Patel, 2013). In people
with adequate income, the mental health problems are experienced by only six out of

Contemporary Debates 5
tem men. Clearly, the deprived group suffers from more physical and mental health
problem as compared to non-deprived population.
Professional practice and its influence
In 2016, the life expectancy gap in England between the people residing in most
deprived areas and least deprived areas was 7.3 years for females and 9.3 years for
male due to the social gradients of inequality in health. However different approaches
have been used by the government in addressing the issues of inequalities in health
due to social gradients. The authority of public health care has moved back to local
government of UK and in this context, Public Health England (PHE) and new structures
of NHS were formed back in 2013. It is recognized by PHE that unsuitable, poor, and
precarious housing impacts the mental and physical health of children, old-age, disables
people, as well as people with long-term medical conditions. It is believed by them that
good health comes from good homes. In this regard, an MOU is signed by UK
government in 2014 with 20 more partners to work together in ensuring that every
individual in the country shall have a decent home for healthier living. The partners of
MOU aim to ensure positive pace in provision of decent homes in the coming years.
Spatial planning for natural environment and built is undertaken by PHE through which
policy is informed and local actions are supported (Publichealthmatters, 2018).
Homeless women and men die at the young age. 43 for women and 47 for men are the
average ages of homeless individuals to die. In comparison to general population, the
general 79.5 years is the average age of males and 83.1 is the average age for females
for living. Physical problems related to health such as addiction problem, diabetes, and
heart diseases are observed in 41% of the rough sleeper while it is observed in only
28% of the general population. Also, 45% are diagnosed with issues related to mental
health and in comparison to 25% of general population. In this regard, the Homeless
reduction Act came into force in 2017 to control the rising homeless population in UK. A
statutory duty is placed on local authorities under this act to reduce homelessness. The
purpose of this act is to analyze the homelessness pattern across UK and take
promising interventions for prevention of homelessness.
The people who are living in the most deprived areas are expected to spend 20 less
years in good health in comparison to those who are living in least deprived areas.

Contemporary Debates 6
Health Equity Collection page is developed by PHE to put together all the resources
related to health inequalities so that the relevant data, tools and evidence can be
identified easily and better actions can be taken to reduce it. Over 30 resources are
contained in this page and it also shows the driving factors of differences in the life
expectancy between least and most deprived communities. For example, it shows
respiratory diseases, cancer, and CVD are the major factors for the life expectancy
differences. In addition to this, a guide for reducing the inequalities in health is published
under which actions are set out for local health systems so that an impact can be made.
It also contains segment tools which provide information related to the causes of death
which drives the life expectancy inequalities at the level of local area. This information is
used further to target the reasons behind the deaths which contribute in the differences
of life expectancy and significantly reduce the inequalities in health
(Publichealthmatters, 2018).
Reduction in equalities related to health means equal opportunities shall be given to
everyone irrespective of who they are and their place of living. People residing in most
deprived locations of UK lives 20 years less in good health as compared to those
residing in leas deprived areas. In order to tackle these inequalities, more attention is
given to the population who are at greater risk of poor health. The core mission of PHE
is to reduce the inequalities in health. In this context, the location actions are done in
support of the reducing the health inequalities. Four areas including promotion of good
quality of jobs, reduction in social isolation, improvement in health literacy, and use of
Social Value Act are promoted. The Social Value Act came into existence in 2013.
Under this act, all the commissioners of public sector are required to consider the
procurement activities for improvements in the environmental, social, and economic
wellbeing of their population. This includes provision of housing and work opportunities
for unemployed people. The features related to the provision of quality work include
protection from any kind of physical hazards, adequate payment, and security against
the jobs (Publichealthmatters, 2015). By providing quality jobs, the deprived population
is able to generate higher income for living and raise their standard of living. With better
standards of living they are able to provide education to their children and save them
mental and physical problems at the initial stage of their lives. This has resulted in

Contemporary Debates 7
improvement in the mental health of the individuals as social isolation is reduced due to
engagement in work and participation in social gatherings. With reduction in
unemployment, the deprived population in UK is able to receive education which
improved the health literacy among them. Literacy towards health enables the individual
to distinguish between what is good and what is bad for health (Sorensen, et al., 2012).
For example, a literate person will know the benefits of consuming health diet and
harmful effects of tobacco and alcohol consumption on health while an illiterate person
will not be able to do so. Therefore, these factors aids in reducing the health inequality
gap in UK.
Political factors influencing social inclusion
Political factors also play a significant role in influencing social inclusion. In UK, the
Department of Health, Secretary of State of Health, and Parliament are responsible for
the general policy and health legislation. Under the Health Act (2006), it is the legal duty
of Secretary of State to promote health service which provides charge free care in
addition to the exiting services. NHS also has the right to provide care irrespective of
discrimination and also provide services such as planned hospital care and emergency.
The stewardship of overall health of the system is provided by Department of Health
and responsibility to run daily operations of NHS is held by NHS England which is a
separate body. The provision of these services does not depends on any kind of social
factors such as area of residence and education level etc and therefore aids in
improving the inequalities in healthcare by providing equal treatment to everyone who is
in need. In addition to this, the NHS budget is also set by NHS England to ensure that
the objectives set by Secretary of Health are met which includes health goals as well as
efficiency. The local government holds the public health budget for improving the health
and well-being boards so that the coordination between the local services can be
improved and also the health disparities can be reduced. In practice, NHS pays and
provides preventive services which include immunization, screening, vaccination
programs, dental care, mental health care, eye care, and services for those with
disabilities in learning such as palliative care (Commonweakthfund, 2019). All these
efforts are put forward by the government to provide equal healthcare services to all
individuals in UK and reduce the inequalities in health.

Contemporary Debates 8
References
Barry, M.M., Clarke, A.M., Jenkins, R. and Patel, V. (2013) A systematic review of the
effectiveness of mental health promotion interventions for young people in low and
middle income countries, BMC public health, 13(1), p.835.
BMA (2016) Collectove-voice. [Online]. Available at: https://www.bma.org.uk/collective-
voice/policy-and-research/public-and-population-health/health-inequalities (Accessed:
24 March, 2019).
Commonwealthfund (2015) Countries. [Online]. Available at:
https://international.commonwealthfund.org/countries/england/ (Accessed: 24 March,
2019).
Koshy, G. and Brabin, B.J. (2012) Parental compliance-an emerging problem in
Liverpool community child health surveys 1991-2006, BMC medical research
methodology, 12(1), p.53.
Lee, A.C., Katz, J., Blencowe, H., Cousens, S., Kozuki, N., Vogel, J.P., Adair, L., Baqui,
A.H., Bhutta, Z.A., Caulfield, L.E. and Christian, P. (2013) National and regional
estimates of term and preterm babies born small for gestational age in 138 low-income
and middle-income countries in 2010, The Lancet Global Health, 1(1), pp.e26-e36.
Publichealthengland (2015) Government. [Online]. Available at:
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/
attachment_data/file/460710/4b_Health_Literacy-Briefing.pdf (Accessed: 24 March,
2019).
Publichealthmatters (2018) a guide to out new equity health collection. [Online].
Available at: https://publichealthmatters.blog.gov.uk/2018/01/16/a-guide-to-our-new-
health-equity-collections-page/ (Accessed: 24 March, 2019).
Publichealthmatters (2018) Addressing health inequalities at local level. [Online].
https://publichealthmatters.blog.gov.uk/2015/09/16/addressing-health-inequalities-at-
local-level/ (Accessed: 24 March, 2019).
Publichealthmatters (2018) Improving health and care through the home. [Online].
Available at: https://publichealthmatters.blog.gov.uk/2018/03/20/improving-health-and-
care-through-the-home/

Contemporary Debates 9
Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z. and
Brand, H. (2012). Health literacy and public health: a systematic review and integration
of definitions and models, BMC public health, 12(1), p.80.