This article titled “Health inequality gap ‘is still growing’ in England, new Department of Health data shows” was written by Denis Campbell Health policy editor, for The Observer on Saturday 12th August 2017 21.00 UTC
The health gap between rich and poor is growing in England, according to shocking figures compiled by the Department of Health.
Despite government pledges to reduce inequalities in areas such as life expectancy and susceptibility to disability and disease, those living in the most deprived areas of the country run a greater risk of premature death, seeing a child die soon after it is born, and of ending up in hospital as an emergency case. Differing health outcomes for the rich and the poor were identified by Theresa May last year as a “burning injustice”.
The health department data shows that in key areas the gap has widened since 2010 after narrowing over the previous decade. Seven years ago life expectancy for men in England’s most deprived areas was 9.1 years less than for those in the richest areas. By 2015 the figure had risen to 9.2 years. The equivalent gap for poor women also grew over that time, from 6.8 years to 7.1 years. The stark statistics are contained in the health department’s annual report, published this summer.
They have been seized on by David Buck, a senior fellow at the King’s Fund health thinktank and a leading expert in public health and health inequalities. Buck told the Observer: “These are shocking figures. It’s shocking that we live in a developed country where inequalities in health are so wide and are getting worse.
“For the poorest in the country this is a double whammy of early death and poorer health while still alive. They are going to die younger and are facing 20 more years of life spent in poor health relative to the richest. This should be a wake-up call to ministers.”
He said that the negative trend indicates that ministers and the NHS are failing to take effective action to end decades-long inequalities in outcomes.
The analysis is the latest evidence of health inequalities in England. Last week a University of Manchester study revealed that people living in the north of England were 20% more likely to die before the age of 75 than those living in the south.
Taking into account 15 indicators, the department’s data shows that rates of death from cancer, heart attacks and strokes are rising among residents of the poorest places compared with those in wealthy areas. The gap between rich and poor in relation to “healthy life expectancy” – defined as a life free of disease or disability – has recently widened to almost 20 years. Poorer people’s access to GP services is also getting worse, as is their experience of care received at GP surgeries.
Tom Cottam, policy manager at Macmillan Cancer Support, voiced dismay at the “inexcusable” socio-economic gap in the risk of dying from the disease. “Your chances of dying of cancer should not depend on where you live or your background, so the fact that there is a growing difference between the least and most deprived groups is a serious concern,” he said.
“The government, NHS England and local cancer services need to work together to address this inexcusable unfairness, and improve survival rates for people diagnosed with cancer, regardless of where they are from.”
Professor Neena Modi, president of the Royal College of Paediatrics and Child Health, said government policies had contributed to widening health inequalities. “Health in infancy and childhood sets the scene for lifelong health, so we view with dismay data from the Department of Health showing that inequality in infant mortality has widened. In the UK – one of the richest countries in the world – the gap between rich and poor is growing and the problem starts in infancy.
“These new data provide further evidence that current policies are not merely failing to tackle health, but are making matters worse. Incremental improvement in population health and wellbeing requires clear, sustained focus and determination. Yet perverse fragmentation of healthcare, growing diversion of funds into for-profit providers, and seemingly deliberate alienation of the health workforce, have been plain to see in recent months. There has been a failure to tackle the scandal of junk food, curb air pollution, and deliver preventive healthcare.”
According to Buck, the NHS was failing on three key challenges: “It is doing too little to manage people with ambulatory care-sensitive conditions such as asthma,” he said, “as well as too little to stop patients with acute conditions ending up in hospital as emergency admissions, and too little to reduce premature mortality.”
A department spokeswoman said that health inequalities were proving difficult to eradicate. “Health inequality is a challenging and complex area. [It is] deeply rooted, difficult to turn around and driven by a variety of factors. Progress is being made – cancer survival rates are at a record high and smoking rates are at an all-time low – but there is still too much variation.”
She added that ministers were giving local councils £16bn over five years to improve public health.
Norman Lamb, the Liberal Democrat shadow health secretary, said: “Any widening in health inequalities can only be considered a failure of policy and we are committed to developing an approach to reduce wholly unacceptable health inequalities. The government must now develop a clear national strategy to reduce health inequalities as a matter of urgency.”
A spokesman for NHS England said: “Health inequalities cost lives. While there are encouraging signs on improved mortality amenable to healthcare and lower smoking rates – which account for up to half of the class-related differences in life expectancy – clearly action is still needed on the wider social determinants of health.”
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