New research highlights why health inequality needs to be at the top of the political agenda

New research has laid bare the huge economic and social inequalities that impact health outcomes across England, with one million people dying prematurely as a result in the decade after 2011.

The findings were featured in a report by The Institute of Health Equity at University College London, led by Sir Michael Marmot, Health Inequalities, Lives Cut Short. In contrast to the traditional focus on the health of the poorest, it considers the life expectancy of the 90% of the general population who do not live in the 10% of wealthiest areas. It found that between 2011 and 2019, 1,062,334 died earlier than they would have done if they lived in the areas where the richest 10% live. Additionally in 2020, during the pandemic, inequality between the least and most disadvantaged 10% of areas contributed a further 28,000 excess deaths, when compared to the previous five years.

The report also found that in 2014 both males and females in the UK had a higher average number of healthy years lived than those in the EU. By 2017, however, the figure had stagnated for men and fallen for women whereas it had increased by more than two years in the EU in the same period. Consequently, 10 EU countries had a higher number of healthy lived years than the UK for males, and 14 had higher than the UK for females.

There have been other stark warnings of the impact that disadvantage is having on health outcomes. In October 2023, analysis by Cancer Research UK estimated that there are an additional 33,000 cases of cancer in the UK each year as a result of deprivation. Later diagnoses and poorer outcomes are a feature not just of cancer but of other serious health issues such as heart disease and diabetes. Women living in the most deprived areas, especially those from ethnic backgrounds, have the highest maternal mortality rates and people living in deprived areas are much more likely to experience poor mental health.

Sir Michael Marmot published a landmark review into health inequalities in the UK in 2010 and the Institute followed it up with a further review in 2020 which found that life expectancy had stalled, with the worst outcomes in the most deprived areas. Following this latest study he has called on political leaders to prioritise not only public health but the social determinants of health - the conditions in which people are born, grow, live, work and age. There is no doubt that the issue will be a political football over the coming months as we approach a general election.

The Purpose Coalition is working with organisations across the country to tackle inequality and the lack of opportunity it brings. Our members are delivering a positive social impact in the communities they serve, helping to break down the barriers that can prevent people in the most disadvantaged areas from improving their lives. Providing more skilled, long-term employment opportunities, building sustainable communities and improving health and wellbeing are all integral to a purpose-led organisation's mission.

The Coalition is also working with NHS Trusts, highlighting the best practice that many of them are already employing - often tailored to the particular issues their communities face - to address health inequality in their areas, including Kent & Medway Partnership and Social Care Trust, South Warwickshire University NHS Foundation Trust, Airedale NHS Foundation Trust and Shropshire Community Health NHS Trust. 

It has also been working cross-party with policymakers and politicians to initiate discussions and explore solutions. Shadow Health and Social Care Secretary, Wes Streeting, who launched the Coalition’s advocacy campaign, Your local NHS: Be at the heart of it, has confirmed that if the Labour Party is the next party of government, it will aim to ‘build a fairer Britain where everyone lives well for longer’. He acknowledges that for NHS Trusts it is not just about delivering healthcare but about being anchor institutions in the communities they serve, providing jobs and opportunities to people and working in partnership with other parts of the public sector as well as the business and voluntary sector. In an election year, the Purpose Coalition will continue to work with our partners to tackle inequality in all its forms and shape a fairer future.