HEALTH MATTERS: Health inequalities are a real issue we all need to work on
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Our public health department has two principal priorities as part of our work to improve and protect the health of people in Highland and Argyll & Bute, writes Dr Tim Allison. These priorities are to support work that prevents ill health and to reduce health inequalities.
Prevention is relatively easy to understand, if harder to deliver, but what are health inequalities? They are unfair and avoidable differences in health across the population and between different groups within society.
Health inequalities relate to groups of people rather than individuals. We find that poor health and reduced life expectancy is more likely for example among those who live in areas where people have lower income and among some minority groups. Poor health does not affect everyone among these groups, but it is more common.
Health inequalities are a feature of populations rather than individuals and no one would go to their doctor and complain of having a health inequality.
However, they do matter. Across NHS Highland men who live in the top fifth of areas in terms of income and wealth have a life expectancy which is more than eight years higher than those in the fifth of areas with lowest income and wealth. This gap is getting bigger.
Other factors affect life expectancy too. People who have a learning disability or serious mental illness can on average expect to live fewer years than others.
There are many underlying causes for health inequalities, and these include things such as education, employment, housing and access to services.
Just as there are many causes there are no simple solutions, but there are certainly things that we can do to improve the health of those who are likely to have the poorest health and wellbeing. If we can work on many individual areas, that can add up to a big change.
One example is money. Health inequality and money are closely related, and many people are facing money worries and debt at the moment. Help is available and there is a useful leaflet on the council website as well as an app for phone regarding dealing with worrying about money.
The influences on health inequalities often go beyond the work of the NHS, but the NHS does have a vital role to play.
Most countries in the world have good health services that help people when they are sick.
Throughout the world people praise the dedication of staff who work in communities and in hospitals. The same is true here with the NHS. What is special about the NHS is not that it treats the sick, but that it treats everyone, rich and poor, and almost entirely without individual payment.
Perhaps we take this for granted and the NHS is certainly not alone in doing this. There are still many health inequalities that we see in NHS services, but the way the NHS is available for everyone does show how one aspect of health inequalities can be approached.
– Dr Tim Allison is Director of Public Health and Policy at NHS Highland.
