The two phrases ‘health inequalities’ and ‘health inequities’ are often used interchangeably to refer to differences in the health status of varied population groups. In fact, both are not synonymous (1,2). Health inequalities arise from the often-inescapable consequences of varied biological and external factors that influence a person’s health status. In contrast, health inequities are unjust and avoidable differences that affect not only an individual’s health but also those of groups already considered disadvantaged due to health inequality (1,2).
By addressing what constitutes health inequality and providing examples of how the inequalities gap for certain outcomes is widening. This assignment aims to put forward and discuss how wider determinants of health and differences in access to services contribute to this growing inequality.
Inequalities in health
To classify where health inequality exists, it becomes necessary to define the meaning of the word ‘health’. According to the World Health Organisation (WHO), it is not merely the absence of disease, but a state of complete physical, mental and social well-being (1,3). Thus, a person’s health not only relates to the presence and absence of physical disease, but also encompasses wider social determinants, such as housing and education (4). Meaning that when referring to health inequalities between individuals and more broadly of populations, it becomes necessary to observe their position in society, e.g. socioeconomic groups (2,5). Any resulting disparity in the standard of health between individuals, groups or populations based on their socioeconomic standing, race or gender is then known as the inequalities gap (6).
Examples of the widening inequalities gap
Numerous reports, including the Black Report (1980) (7), Acheson Report (1998) (8) and Marmot Review (2010) (1,9) have highlighted that despite increases in the overall health of the population, there remains a disparity in the standard of health of individuals and populations from different socioeconomic groups. For example, the Marmot Review illustrates that individuals from poorer neighbourhoods have decreased life expectancies in comparison to their counterparts from wealthier neighbourhoods (9). All these reports agree there is a ‘social gradient’ of health; meaning lower socioeconomic groups have a significantly poorer quality of health relative to those of higher socioeconomic groups (7-9). In many cases this gap is seen to be widening as in the last 80 years mortality rates between the lower social classes and more affluent groups has increased (10). The cause of this higher mortality is likely linked to an increased occurrence of disease in lower socioeconomic groups and faster rates of health improvement in the higher social classes (11).
Historically, ‘diseases of affluence’, which include chronic conditions such as obesity, diabetes and cardiovascular disease, were associated with wealthy and affluent socioeconomic...