Read: The health inequality crisis: Time is running out

The health gap is big and getting bigger. Further stark evidence – if it were needed – was published this week on the extent of health inequalities across England.

New research from the Health Foundation paints a depressing, but all too familiar, picture of health disparity in this country. Its results then are all the more shocking given that it is likely to be the most accurate information we have seen to date, based on data detailing patients’ interactions with primary care and hospital services rather than self-reported data.

A man of 60 in the most deprived 10% of the country typically experiences the ill-health experienced by a man of 70 in the wealthiest 10%. Despite spending a greater amount of their lives with diagnosed illness – 46% compared to 44% - men in the most deprived areas spend less time living with diagnosed illness – 26 years compared with 38 years in the least deprived areas. With a life expectancy of 78, this is nine years less than men in the richest areas of the country.

While inequality in life expectancy is greater for men than for women, women face greater disparity in the amount of time spent with diagnosed illness. Women from the most deprived areas spend 52% of their life with diagnosed illness while their better-off peers spend 46%. Women in England’s poorest places are diagnosed with a long-term illness at an average age of 40, compared to 48 in the most prosperous places. A 60-year-old woman in England’s poorest areas typically has the same level of illness as a woman 16 years older in the richest areas, and her life expectancy is five years shorter.

 The research also looked at disparities based on region, ethnicity and age. It found that people in the north of England have the highest health care needs, with just four conditions – chronic pain, alcohol problems, COPD and cardiovascular disease – accounting for 83% of the inequality between that region and the East of England which has the lowest levels of illness. It also showed that people in poorer areas have greater levels of multiple diagnosed illness, again concentrated in the same few conditions but also including diabetes and anxiety and depression.

 There are higher levels of diagnosed ill-health among people of Pakistani, Bangladeshi and black Caribbean ethnic backgrounds than among those from white ethnic backgrounds.

 The analysis also found that health inequalities start at an early age with higher rates of diagnosed mental health conditions, chronic pain and alcohol problems already developing in the late teens and early twenties. They tend to grow across the life cycle and into old age.

These findings underline what previous research has also found, notably that by Sir Michael Marmot who has examined health equality at ten-year intervals, in 2010 and 2020. He also concluded that improvements to life expectancy have stalled, with a growing gap between wealthy and deprived areas, and that more people will be spending more of their lives in poor health. He highlighted that for both men and women, the largest decreases in life expectancy were seen in the most deprived 10% of neighbourhoods in the Northeast and the largest increases in the least deprived 10% of neighbourhoods in London.

 As with all aspects of levelling up, the situation on the ground is often more complex, with even the most privileged areas of the country containing pockets of significant deprivation. What is clear is that we are currently failing the communities most in need of support. Experts in the field, like Sir Michael, have been calling for action with every piece of detailed evidence they produce. The implications not only for those people’s wellbeing and prosperity but also for their health and social care systems, and our economy are huge.  

 The Government health strategy for women, launched last month, was a positive step in addressing the gender health gap but, as this research has shown like countless other pieces of research and reports, there is still so much more to do to reduce health inequality. The long-awaited White Paper on Health Disparities will be an indication of whether the new Prime Minister and their health team recognise the urgency of the situation, and whether their plan is ambitious enough to tackle it.

 The latest report from the Health Foundation will not come as any surprise to policy makers or politicians. The big question is whether they are going to take any notice of it and take meaningful, concerted action to stop the rising tide of health inequality. There will be significant social and economic consequences if they do not act as a matter of urgency.