Health Inequalities

Put simply, health inequalities, are the observed differences in health and well-being between different groups in society.

People form, and are part of, many different groups (in which individuals share some common feature) – but the main factors affecting overall health are socio-economic group (or social class), age, gender, ethnicity, geographical location and education.

It is quite possible for the health of a population to rise overall, whilst inequalities in health between different groups become larger.

Figure 1: The Widening Mortality Gap Between the Social Classes in England and Wales

*1979-83 excludes 1981
England and Wales. Men of working age (varies according to year, either aged 15 or 20
to age 64 or 65)
Source: Office for National Statistics, Decennial Supplements, analysis by DH Statistics Division

During the 20th century there were considerable improvements in the nation’s overall health.   For example, the life expectancy of a woman at birth is about 80 years today compared with 48 years in 1900; for men it is 75 years, compared with 44. Over the same period infant mortality has fallen from over one in ten to six per 1,000.  

Unfortunately these improvements have not always been achieved at a similar rate among all social groups, or in all parts of the country. In particular, people in lower socio-economic groups tend to be ill more often and to die sooner and suffer more long-standing and limiting illnesses.  For example, the death rate in men under 65 years is 1.6 times higher in the North West Region than in the South East of England.

Health inequalities begin very early in life, even before conception (for example, educated women are more likely to take folic acid before pregnancy) and continue throughout life. They also cross generations, affecting the life chances and quality of life for adults, their children and grandchildren. Babies born to poorer families are more likely to be premature, are at greater risk of infant mortality and have a greater likelihood of poverty, impaired development and chronic disease later in life. 

Because of the impact of health inequalities, there are now major health inequalities targets across the UK:

Tackling health inequalities requires many different approaches - often involving Government action in the redistribution of wealth - but also by breaking the cycle of ill health through tackling the broader determinants of health and factors that particularly influence the health of those on low incomes.