Health inequalities are the stark and often unjust differences in health outcomes seen across various population groups. These disparities may present themselves as variations in life expectancy, the prevalence of chronic diseases, and access to healthcare services. These inequalities are shaped by a myriad of factors, including socio-economic status, ethnicity, geography, and lifestyle choices.
Rooted in the wider determinants of health—such as housing, education, employment, and access to green spaces—health inequalities are a pressing concern. For instance, individuals living in deprived areas may struggle to access quality healthcare, nutritious food, and safe environments, all of which negatively impact their health. Furthermore, certain groups, including Black, Asian, and minority ethnic communities, and people experiencing homelessness, are disproportionately affected by poorer health outcomes.
The COVID-19 pandemic illuminated these disparities, with vulnerable populations bearing the brunt of the crisis. Addressing these issues requires concerted efforts and targeted initiatives like the National Healthcare Inequalities Improvement Programme and the Core20Plus5 approach. Health inequalities are estimated to cost the NHS an extra £4.8 billion a year, society around £31 billion in lost productivity, and between £20 and £32 billion a year in lost tax revenue and benefit payments. Health is therefore a major determinant of economic performance and prosperity.
Councils are pivotal in addressing health inequalities. They oversee a wide range of services that directly influence community health and wellbeing, including social care, education, housing, and environmental health. By collaborating closely with local communities, businesses, and organisations, local authorities can develop targeted interventions to improve health outcomes.
Moreover, councils possess the power to influence policies and practices that can mitigate health inequalities. Through implementing programs to promote healthy lifestyles, enhancing access to healthcare services, and creating safer environments, local authorities can drive meaningful change. Additionally, collaborating with regional and national bodies ensures that health inequalities are tackled at all levels of governance.
Despite the dedicated efforts of elected members and officers, addressing health inequalities remains a complex challenge. Funding constraints, varying service provisions, and the need for coordinated action across sectors can impede progress. However, there are numerous opportunities for innovation and collaboration. By leveraging local knowledge and resources, local governments can develop tailored solutions that meet the unique needs of their communities.
Health inequalities represent a significant public health issue that demands a multifaceted approach. Councils are at the forefront of this endeavour, striving to create healthier, more equitable communities through targeted interventions and collaborative partnerships. By addressing the wider determinants of health and advocating for inclusive policies, local authorities can help bridge health disparities and enhance the overall wellbeing of their residents.
Councillor David Fothergill
Chair, LGA Community Wellbeing Board
The domains of health inequality
Protected characteristics
Age, disability, gender reassignment, marriage and cival partnership, pregnancy and maternity, race, religion or belief, sex, sexual orientation
Socio-economic deprivation
Includes impact of wider determinants, for example education, low-income, occupation, unemployment and housing.
Inclusion health and vulnerable groups
For example Gypsy, Roma Travellers and Boater communities, people experiencing homelessness, offenders, former offenders and sex workers.
Geography
For example, population composition, built and natural environment, levels of social connectedness, and features of specific geographies, such as urban, rural and coastal.
Further reading
Addressing health inequalities through collaborative action (GOV.UK)
Further information about the domains of health inequality (adapted from Place-based approaches to health inequalities) can be found on page 6.
These domains interact with each other to benefit or disadvantage different people or groups. To address this, resources and action need to be allocated proportionate to need in order to deliver equitable outcomes.