An article examined the socio-economic inequalities in survival and provision of neonatal care among very pre-term infants. Mothers from the most deprived areas were nearly twice as likely to have a very pre-term infant compared with those from the least deprived areas, and consequently there were nearly twice as many deaths due to very pre-term birth in the most deprived areas.
Source: Lucy Smith, Elizabeth Draper, Bradley Manktelow and David Field, 'Socioeconomic inequalities in survival and provision of neonatal care: population based study of very preterm infants', British Medical Journal, 5 December 2009
Links: Article | Leicester University press release
Date: 2009-Dec
An article proposed a new approach to the measurement of inequality and inequity in the delivery of healthcare, based on contributions from the literature on poverty and deprivation. It applied this approach to the case of the effect of family doctor fundholding reform on equity in the National Health Service in England.
Source: Mauro Laudicella, Richard Cookson, Andrew Jones and Nigel Rice, 'Health care deprivation profiles in the measurement of inequality and inequity: an application to GP fundholding in the English NHS', Journal of Health Economics, Volume 28 Issue 6
Links: Abstract
Date: 2009-Dec
An article examined research literature on ethnicity data collection related to health. There was a paucity of published evidence. Many clinical articles used ethnicity data: but few discussed the methodology of data collection. Self-reported ethnicity was recognized as the best method of data collection, and was preferable to observer assessment. Training was needed to raise awareness of the importance of ethnicity data and its use to facilitate the reduction of inequalities.
Source: Gulnaz Iqbal et al., 'Improving ethnicity data collection for health statistics in the UK', Diversity in Health and Care, Volume 6 Number 4
Links: Abstract
Date: 2009-Dec
An article said that care home residents were missing out on access to specialist care from older people's doctors, contrary to official guidance.
Source: Claire Steves, Rebekah Schiff and Finbarr Martin, 'Geriatricians and care homes: perspectives from geriatric medicine departments and primary care trusts', Clinical Medicine, Volume 9 Number 6
Links: Article | BGS press release | Community Care report
Date: 2009-Dec
An article examined social inequalities in mortality for women aged 25-59 in England and Wales in the period 2001-03. There was a strong socio-economic effect on the mortality of women in all regions. Compared to women in the most advantaged class, mortality rates were three times as high for the least advantaged women for lung cancer and cerebrovascular disease, around five times as high for ischaemic heart disease and all digestive diseases, and six times as high for respiratory diseases.
Source: Ann Langford, Brian Johnson and Alaa Al-Hamad, 'Social inequalities in female mortality by region and by selected causes of death, England and Wales, 2001-03', Health Statistics Quarterly 44, Winter 2009, Office for National Statistics, TSO (0870 600 5522)
Links: Article | ONS press release
Date: 2009-Nov
An article examined the effects of area-level same-ethnic density on maternal and infant health, independent of area deprivation and individual socio-economic status, in five minority-ethnic groups. There was a protective effect of ethnic density for limiting long-term illness among Bangladeshi mothers at 5-30 per cent density and Pakistani mothers at all higher densities. For some measures of maternal health, in some ethnic groups, the psychosocial advantages of shared culture, social networks and social capital might override the adverse effects of material deprivation.
Source: Kate Pickett, Richard Shaw, Karl Atkin, Kathleen Kiernan and Richard Wilkinson, 'Ethnic density effects on maternal and infant health in the Millennium Cohort Study', Social Science & Medicine Volume 69 Issue 10
Links: Abstract
Date: 2009-Nov
An article examined the association between socio-economic position and physical disability at older ages, using data from the English Longitudinal Study of Ageing. Socio-economic circumstances affected the prevalence and scale of physical disability even at older ages. In particular, wealth appeared more important as a socio-economic factor for physical disability than social class or education. Socio-economic gradients in physical disability were greater for men than for women and for those in the younger age groups.
Source: Edlira Gjonca, Faiza Tabassum and Elizabeth Breeze, 'Socioeconomic differences in physical disability at older age', Journal of Epidemiology and Community Health, Volume 63 Number 11
Links: Abstract
Date: 2009-Nov
The report of an official review examined age discrimination and age equality in the health and social care sector in England. It included a recommendation to implement the Equality Bill's age discrimination ban in health and social care at the same time as in other sectors. The government said that it was 'minded to accept' the review's recommendation on the timing of implementation.
Source: Ian Carruthers and Jan Ormondroyd, Achieving Age Equality in Health and Social Care, Department of Health (08701 555455) | House of Commons Hansard, Written Ministerial Statement 22 October 2009, column 72WS, TSO (0870 600 5522)
Links: Report | Annex | Hansard | NHS press release | WRVS press release | RCPsych press release | Guardian report | Telegraph report | Community Care report
Date: 2009-Oct
An article said that between 1997 and 2007 waiting times for patients having three common surgical procedures in England went down, and the variation in waiting times for them across socio-economic groups was reduced – contrary to fears that the government's National Health Service reforms would lead to inequity.
Source: Zachary Cooper, Alistair McGuire, Simon Jones and Julian Le Grand, 'Equity, waiting times, and NHS reforms: retrospective study', British Medical Journal, 3 September 2009
Links: Article | Abstract | FT report
Date: 2009-Sep
The inspectorate for healthcare and social care examined programmes designed to reduce inequalities in cardiovascular disease, the largest contributor to health inequalities, and how well primary care trusts were meeting variations in need in their local areas. It said that there was a lack of consistency in outcomes for patients, suggesting the need for better adherence to policy and guidance on effectiveness; that financial incentives had a positive impact in improving performance and reducing inequalities; and that there was a need for more data to allow better targeting of programmes and services at the people who needed them most.
Source: Closing the Gap: Tackling cardiovascular disease and health inequalities by prescribing statins and stop smoking services, Care Quality Commission (03000 616161)
Links: Report | CQC press release
Date: 2009-Sep
An article examined what could be learned, from a health inequalities policy perspective, about resilience in low-income households if: the voices of people experiencing hardship were heard; resilience were conceptualized as a process, rather than as an individual trait; and the social context and conditions that helped or hindered that process of resilience were identified. The transitions that people in poverty had made in their lives had been influenced by the presence of family and community support, respectful attitudes and behaviour on the part of service providers, and the chances offered to them to engage in activities that bolstered self-esteem.
Source: Krysia Canvin, Anneli Marttila, Bo Burstrom and Margaret Whitehead, 'Tales of the unexpected? Hidden resilience in poor households in Britain', Social Science & Medicine Volume 69 Issue 2
Links: Abstract
Date: 2009-Jul
The inspectorate for education and children's services examined the impact of integrated services on children, parents, and families in 20 children's centres in deprived areas. The effective integration of services was having a positive impact in terms of support for children and parents in over half of the centres visited. Three centres were judged as making an outstanding difference. Challenges remained, however, in relation to onward links with primary schools, reaching the most vulnerable families, and developing data on outcomes for parents and children. The least effective partnership working seen was between the children's centres and Jobcentre Plus.
Source: The Impact of Integrated Services on Children and their Families in Sure Start Children's Centres, HMI 080253, Office for Standards in Education, Children's Services and Skills (07002 637833)
Links: Report | OFSTED press release | New Start report
Date: 2009-Jul
A paper said that the introduction of social protection systems, as well as their generosity and coverage, had significant impacts on health. Which person received the benefits within a household affected the health outcomes for the family. There were serious difficulties facing those with long-term medical conditions who were on the margins of the labour force. Collaboration between the health and social protection systems was poor.
Source: Howard Glennerster, Jonathan Bradshaw, Ruth Lister and Olle Lundberg with Kay Withers and Jan Flaherty, Reducing the Risks to Health: The role of social protection, CASEpaper 139, Centre for Analysis of Social Exclusion/London School of Economics (020 7955 6679)
Links: Paper
Date: 2009-Jul
A paper said that existing methods of providing patient information could be increasing health inequalities. Although most patient information was provided in the form of written leaflets or via the internet, around 1 in 5 people did not have basic literacy and struggled to read, and one-third of households did not have a home internet connexion.
Source: Jo Ellins and Shirley McIver, Supporting Patients to Make Informed Choices in Primary Care: What Works?, Health Services Management Centre/University of Birmingham (0121 414 7050)
Links: Paper | Birmingham University press release | Pulse report
Date: 2009-Jun
The interim report was published of a government-commissioned review of strategies for reducing health inequalities from 2010 onwards.
Source: Strategic Review of Health Inequalities in England Post 2010, Marmot Review: First Phase Report, Department of Epidemiology and Public Health/University College London (020 7679 1680)
Links: Report
Date: 2009-Jun
A report examined ways in which primary care trust boards could use commissioning to tackle health inequalities.
Source: The Intelligent Board 2009: Commissioning to reduce inequalities, Dr Foster Ltd (020 7330 0400)
Links: Report | Dr Foster press release
Date: 2009-Jun
A report examined whether a benchmarking system would support the achievement of best value for money from Sure Start children's centres, and whether it would support delivery of their key objectives. It was concluded that the wide variety of management/financial arrangements and structures would make a benchmarking system difficult to implement.
Source: HEDRA, Sure Start Children's Centres: Financial Benchmarking to Ensure Value for Money, Research Report RR123, Department for Children, Schools and Families (0845 602 2260)
Date: 2009-Jun
A report examined the ways in which outreach was being delivered by children's centres and schools offering access to extended services. It said that children's centres and schools were successfully engaging 'hard-to-reach' families – including those affected by poverty, poor living environments, health problems, and other features of social exclusion.
Source: Capacity, Outreach to Children and Families: A Scoping Study, Research Report RR116, Department for Children, Schools and Families (0845 602 2260)
Date: 2009-Jun
A study found that wealth and social class had a greater impact on the health and well-being of elderly people than had previously been realized.
Source: James Nazroo, Inequalities in Health in an Aging Population: Patterns, causes and consequences, Economic and Social Research Council (01793 413000)
Links: ESRC press release | Manchester University press release
Date: 2009-May
An article compared class mobility and deprivation mobility between 1971 and 1991 with health in 1991 in England and Wales. A reduction in inequalities was not a necessary consequence if the health of 'mobile' people fell between that of those they left and those they joined, and this was particularly the case for deprivation mobility.
Source: Paul Boyle, Paul Norman and Frank Popham, 'Social mobility: evidence that it can widen health inequalities', Social Science & Medicine Volume 68 Issue 10
Links: Abstract
Date: 2009-May
An article examined infant mortality in England and Wales during 2005 and 2006 in relation to the level of deprivation of the area in which the mother lived, socio-economic status of the father, marital status, ethnicity of the baby, maternal age, birthweight, maternal country of birth, sex of the baby, and gestational age. Pre-term birth, low birthweight, and smallness in relation to gestational age were associated with deprivation and increased the risk of infant mortality.
Source: Laura Oakley, Noreen Maconochie, Pat Doyle, Nirupa Dattani and Kath Moser, 'Multivariate analysis of infant death in England and Wales in 2005-06, with focus on socio-economic status and deprivation', Health Statistics Quarterly 42, Summer 2009, Office for National Statistics, TSO (0870 600 5522)
Links: Article | ONS press release
Date: 2009-May
The government responded to a report by a committee of MPs on health inequalities. It said that England was widely acknowledged internationally as a leader for its determined and comprehensive approach to reducing health inequalities.
Source: The Government's Response to the Health Select Committee Report on Health Inequalities, Cm 7621, Department of Health, TSO (0870 600 5522)
Links: Response | Hansard | MPs report
Date: 2009-May
An article examined mortality among women of working age (25-59) in 2001-2003 in England and Wales. Mortality for women in routine occupations was around twice as high as that of women in higher managerial and professional occupations.
Source: Ann Langford and Brian Johnson, 'Social inequalities in adult female mortality by the National Statistics Socio-economic Classification, England and Wales, 2001-03', Health Statistics Quarterly 42, Summer 2009, Office for National Statistics, TSO (0870 600 5522)
Links: Article | ONS press release
Date: 2009-May
An article examined the extent to which certain risk factors – poor childhood and adult socio-economic conditions, lower childhood cognitive ability, and cigarette smoking – were part of the same pathway linking childhood experience to adult survival.
Source: Diana Kuh et al., 'Do childhood cognitive ability or smoking behaviour explain the influence of lifetime socio-economic conditions on premature adult mortality in a British post war birth cohort?', Social Science & Medicine Volume 68 Issue 9
Links: Abstract
Date: 2009-May
A report examined developments in health inequalities in England over the previous 10 years. It highlighted the development of evidence-based, practical, and effective policy design and delivery systems. Building on these achievements through further policy development, monitoring, and evaluation offered the prospect of further improvements in the health of disadvantaged groups and areas, and a long-term narrowing of the gap.
Source: Tackling Health Inequalities: 10 Years On – A review of developments in tackling health inequalities in England over the last 10 years, Department of Health (08701 555455)
Links: Report | FPH press release
Date: 2009-May
A study found that people who lived in deprived areas were more likely to die after heart surgery than those from more affluent places, even after allowing for the effects of smoking, obesity, and diabetes.
Source: Domenico Pagano et al., 'Social deprivation and prognostic benefits of cardiac surgery: observational study of 44 902 patients from five hospitals over 10 years', British Medical Journal, 2 April 2009
Links: Article | Birmingham University press release | Guardian report | NHS Choices report
Date: 2009-Apr
An article examined the incorporation of equity considerations into economic evaluation of public health interventions. The potential benefits of considering equity were likely to be largest in cases involving: (a) interventions that target disadvantaged individuals or communities, and that were also relatively cost-ineffective; and (b) interventions to encourage lifestyle change that might be relatively ineffective among 'hard-to-reach' disadvantaged groups, and hence might require re-design to avoid increasing health inequalities.
Source: Richard Cookson, Mike Drummond and Helen Weatherly, 'Explicit incorporation of equity considerations into economic evaluation of public health interventions', Health Economics, Policy and Law, Volume 4 Issue 2
Links: Abstract
Date: 2009-Apr
An article examined examples of policies aimed at improving access to healthcare services for particular groups perceived as being under-served, or served inappropriately, by existing services. Some policies might not work as well as intended, or might even exacerbate inequities of access, because they failed to recognize the source of the particular barriers faced by some groups.
Source: Maria Goddard, 'Access to health care services – an English policy perspective', Health Economics, Policy and Law, Volume 4 Issue 2
Links: Abstract
Date: 2009-Apr
A new book brought together the latest research findings on the social determinants of health.
Source: Salvatore Babones (ed.), Social Inequality and Public Health, Policy Press, available from Marston Book Services (01235 465500)
Links: Summary
Date: 2009-Apr
The healthcare inspectorate said that many National Health Service trusts were falling short of their legal obligations to promote racial equality across the workforce.
Source: Tackling the Challenge: Promoting race equality in the NHS in England, Commission for Healthcare Audit and Inspection (020 7448 9200)
Links: Report | People Management report | Guardian report
Date: 2009-Mar
A report by a committee of MPs said that governments had spent large sums of money on 'social experiments' to reduce health inequalities: but it was not known whether these experiments had worked, or whether the money had been well spent.
Source: Health Inequalities, Third Report (Session 2008-09), HC 286, House of Commons Health Select Committee, TSO (0870 600 5522)
Links: Report | Kings Fund press release | BMA press release | RCP press release | RCN press release | Rethink press release | ASH press release | NHF press release | OHA press release | BBC report | Telegraph report | New Start report
Date: 2009-Mar
An article examined the incidence rate for admission and mortality of children receiving paediatric intensive care in relation to socio-economic status and ethnicity in England and Wales. The admission rate was higher for children from more deprived areas, and 36 per cent higher for children from the south Asian population.
Source: Roger Parslow et al., 'Epidemiology of critically ill children in England and Wales: incidence, mortality, deprivation and ethnicity', Archives of Disease in Childhood, Volume 94 Number 3
Links: Abstract | BBC report
Date: 2009-Mar
The government announced that National Health Service prescription charges would increase by 10 pence (1.4 per cent) per item, from £7.10 to £7.20, with effect from 1 April 2009.
Source: House of Commons Hansard, Written Ministerial Statement 5 March 2009, columns 63-64WS, TSO (0870 600 5522) Links: Hansard | DH press release
Date: 2009-Mar
A survey found that 9 out of 10 parents who used Sure Start children's centres were happy with the service they received. The most popular services were childcare and nursery education.
Source: TNS Social, Sure Start Children's Centres: Survey of Parents, Research Report RR083, Department for Children, Schools and Families (0845 602 2260)
Links: Report | Brief | DCSF press release | Conservative Party press release | Community Care report
Date: 2009-Feb
A report by a committee of peers said that a proposed right to access healthcare across the European Union could worsen health inequalities if fair funding and information systems were not put in place.
Source: Healthcare Across EU Borders: A safe framework, 4th Report (Session 2008-09), HL 30, House of Lords European Union Select Committee, TSO (0870 600 5522)
Links: Report | BBC report
Date: 2009-Feb
An article examined whether wealth gradients in the incidence of illness declined with age; and, if so, whether this decline was explained by differential mortality. Socio-economic inequality in developing new health problems persisted into old age for certain illnesses, particularly functional impairment: but not for heart disease. Selective mortality explained only some of the decline in health inequalities with age.
Source: Anne McMunn, James Nazroo and Elizabeth Breeze, 'Inequalities in health at older ages: a longitudinal investigation of the onset of illness and survival effects in England', Age and Ageing, Volume 38 Number 2
Links: Abstract
Date: 2009-Feb
An article examined the association between poor health and deprivation. There were differences in relative health expectancies between the regions of England and Wales that were not fully explained by differences in socio-economic circumstances. Conventional deprivation measures tended to understate the poorer health performances of the more deprived regions (Wales and the north of England), and the understatement increased with deprivation. The exception to the rule was London, where health expectancies were superior to those that the level of deprivation would suggest.
Source: David Whynes, 'Deprivation and self-reported health: are there "Scottish effects" in England and Wales?', Journal of Public Health, Volume 31 Number 1
Links: Abstract
Date: 2009-Feb
The government published a strategy for improving the health of children and young people. There would be stronger and better joined-up support during the crucial early years of life, including more health visitors; and a strengthened role for Sure Start children's centres with, for the first time, each centre having access to a named health visitor.
Source: Healthy Lives, Brighter Futures: The strategy for children and young people's health, Department of Health (08701 555455) and Department for Children, Schools and Families
Links: Strategy | Summary | Impact assessment | Hansard | DH press release | DCSF press release | RCN press release | Action for Children press release | CPAG press release | NCT press release | CDC press release | NCB press release | Scope press release | Conservative Party press release | Community Care report | New Start report | Guardian report | Pulse report
Date: 2009-Feb
An article examined the engagement of users in service delivery, service planning, and monitoring/evaluation activities for children's centres in Greater Merseyside (in north west England). Research indicated that a lack of time to implement (and develop trust in) the new arrangements, a lack of awareness by users about participation, and a broader remit for children's centres were all hampering the involvement of users. Without such participation there was a real risk that the existing needs of the most disadvantaged groups would not be adequately addressed.
Source: Simon Pemberton and Jennifer Mason, 'Co-production and Sure Start children's centres: reflecting upon users', perspectives and implications for service delivery, planning and evaluation', Social Policy and Society, Volume 8 Issue 1
Links: Abstract
Date: 2009-Jan
An article (by two civil servants) examined the progress made in England in addressing the challenge of health inequalities. There was a need to engage more proactively with the domestic population and with international partners, taking a systematic partnership approach to inform policy, practice, and delivery on the ground.
Source: Fiona Adshead and Allison Thorpe, 'Health inequalities in England: advocacy, articulation and action', Perspectives in Public Health, Volume 129 Number 1
Links: Abstract
Date: 2009-Jan
