What are the reasons for health inequalities in the UK?
Health inequalities are explained in relation to several factors:
- poverty
- lifestyle choices (including smoking, alcohol and drug misuse, diet and exercise)
- gender
- race
Poverty and ill health
Numerous reports since the early 1980s have recognised the links between poverty and poor health. Links were first made by the Black Report in 1980 and further reinforced by the Acheson Report in 1997.
More recently, the Scottish Health Survey provides an annual update on a range of information including health inequalities, as does the Glasgow Central for Population and Health (GCPH).
Evidence of the link between poverty and poor health
The Scottish Health Survey (SHS) 2021, found of those living in the least deprived areas, 87% described themselves as being in good or very good health. This compares to the most deprived where only 60% said their health was good or very good.
Mental health and wellbeing scores also reflected a similar pattern of inequality with those in the most deprived areas having poorer mental health than those in the least deprived areas
The SHS also found in 2021, that people in the most deprived areas reported a greater level of illness compared to the least deprived areas:
| Health-related issues | Least deprived 20% | Most deprived 20% |
| Cardiovascular disease | 13 | 20 |
| Diabetes | 4 | 8 |
| Heart disease | 4 | 10 |
| Stroke | 2 | 5 |
| Health-related issues | Cardiovascular disease |
|---|---|
| Least deprived 20% | 13 |
| Most deprived 20% | 20 |
| Health-related issues | Diabetes |
|---|---|
| Least deprived 20% | 4 |
| Most deprived 20% | 8 |
| Health-related issues | Heart disease |
|---|---|
| Least deprived 20% | 4 |
| Most deprived 20% | 10 |
| Health-related issues | Stroke |
|---|---|
| Least deprived 20% | 2 |
| Most deprived 20% | 5 |
Reasons to explain the link between poverty and poor health
People living on a low income are more likely to:
- have poorer diets
- live in poor quality (damp, lacking heating, etc.) and more overcrowded housing in poorer areas
- have less money to heat or maintain their homes
- have less money to purchase appropriate winter clothing
- experience more stress
These factors taken together significantly increase the chances of an individual experiencing poor health. Poverty can affect a person's mental wellbeing. The stress of worrying about paying bills or surviving on a low income further reduces good health.
The surrounding physical environment may also influence a person's health. Areas that have fewer services (such as shops that sell affordable fresh fruit and vegetables), that lack health and leisure facilities or green space, that have more crime or have many buildings that have fallen into disrepair, create a living environment that is not good for health.
Access to local health services and the quality of service provided may not always be as good in poorer areas. In deprived areas of Scotland, GPs are more likely to have more difficult caseloads.