A report examined new evidence on health inequalities in the European Union, and the policy response at European Union and national level to health inequalities since 2009. It said that there were still significant health inequalities between and within European Union member states and discussed the causes and drivers. It recommended that member states should develop and implement strategies to address health inequalities, with resources and improved data to ensure progress. It also outlined a role for the European Commission in promoting action and building capacity to tackle health inequalities.
Source: Health Inequalities in the EU: Final report of a consortium, European Commission
Links: Report
Date: 2013-Dec
A report provided a summary of findings from a seminar series that considered some of the main challenges facing London's Black, Asian and Minority Ethnic (BAME) children and young people. It said that some progress had been made in addressing racial inequality, but BAME children and young people still faced unequal outcomes in many key areas, such as: education; training; employment; criminal justice; mental health and well-being; and the lack of voice in the development of policy and practice. The report made a range of recommendations in these areas to government and other stakeholders.
Source: Eleanor Stokes and Barbara Nea, Shaping the Future: Getting the best for Black, Asian and Minority Ethnic children and young people – seminar series report, Race on the Agenda (ROTA)
Links: Report | ROTA press release
Date: 2013-Dec
An article examined theories of what causes health inequalities, and evaluated the evidence in light of epidemiological research since the Black Report of 1980. Health inequalities could not be expected to reduce substantially as a result of policy aimed at changing health behaviours, particularly in the face of wider public policy that militated against reducing underlying social inequalities. Political rhetoric about the need for 'cultural change', without changes in the distribution of power, income or wealth, or in regulatory frameworks, was likely to divert from necessary action.
Source: Gerry McCartney, Chik Collins, and Mhairi Mackenzie, 'What (or who) causes health inequalities: theories, evidence and implications?', Health Policy, Volume 113 Issue 3
Links: Abstract
Date: 2013-Dec
An article examined the widening of inequalities in anxiety and depression over the lifecourse, drawing on a study in the west of Scotland. Differential persistence and symptom progression indicated that intervening to prevent or treat symptoms earlier in life was likely to reduce socio-economic inequalities later: but attention also needed to be given to late adulthood where differential incidence emerged more strongly than differential persistence.
Source: Michael Green and Michaela Benzeval, 'The development of socioeconomic inequalities in anxiety and depression symptoms over the lifecourse', Social Psychiatry and Psychiatric Epidemiology, Volume 48 Number 12
Links: Abstract
Date: 2013-Dec
An article examined how ready or vulnerable each primary care organization in England was in 2010 to the National Health Service reforms proposed by the coalition government, which were enacted by the Health and Social Care Act 2012. Areas with higher concentrations of older people were not correlated with vulnerability except where there was also deprivation. This contrasted with widespread qualitative and quantitative evidence of sub-optimal care of older people – suggesting that there might be an over-reliance on using activity, which was proportionately higher in the least vulnerable areas, to determine funding and quality markers rather than outcomes. A risk of the reform process could be a negative impact on deprived areas that appeared to be financially less secure and more likely to have long-established health inequalities.
Source: Jose Iparraguirre, Tom Gentry, and Diego Pena, 'Vulnerability of primary care organizations to the National Health Service reform in England', Applied Economic Perspectives and Policy, Volume 35 Issue 4
Links: Abstract
Date: 2013-Dec
A report prepared for the Northern Ireland Assembly examined the health inequalities affecting people with a learning disability. It said that, despite two action plans and a service framework for learning disability, progress to reduce health inequalities had been slow. It suggested actions including: the identification of people who were not known to services; collection of appropriate learning disability population data; ensuring all family doctors were involved in the health check scheme; and the improvement of health promotion/screening.
Source: Health Inequalities and People with a Learning Disability, Research Paper 134/13, Research and Information Service, Northern Ireland Assembly
Links: Report
Date: 2013-Nov
A report examined dementia care provision for people from black, Asian and minority-ethnic groups. It said that there was a growing body of evidence that the black African-Caribbean community in the United Kingdom had a higher prevalence of vascular dementia than other communities, and that prevalence of dementia in some communities had been significantly underestimated. It said that the existing dementia strategy should be implemented appropriately and the information and support needs of black and minority-ethnic communities met.
Source: David Truswell, Black, Asian and Minority Ethnic Communities and Dementia: Where are we now?, Race Equality Foundation
Date: 2013-Nov
A report said that there was a looming capacity crisis in ophthalmology services in England. It said that increased demand, a lack of strategic direction, poor local planning of services, and inconsistent commissioning practices were behind patients' reports of cancellations of appointments and delays in treatment. The report recommended a range of urgent actions, including an inquiry.
Source: Saving Money, Losing Sight: RNIB campaign report, Royal National Institute of Blind People
Links: Report | Summary | RNIB press release | BBC report | Telegraph report
Date: 2013-Nov
A report examined research during the past year from research organizations and charities, to explore what was known about end of life care. The report examined the influence of marital status and ethnicity on place of death, patient experience, the role of community, and palliative care. The report noted large geographic variations in the proportion of deaths in hospital, but said the proportion of people dying at home or in care homes increased from 38 per cent in 2008 to 44 per cent in 2012.
Source: What We Know Now 2013: New information collated by the National End of Life Care Intelligence Network, Public Health England
Links: Report | PHE press release | Guardian report
Date: 2013-Nov
A report provided an atlas of diagnostic services within the National Health Service in England. It highlighted geographical variation in the provision of services.
Source: The NHS Atlas of Variation in Diagnostic Services: Reducing unwarranted variation to increase value and improve quality, RightCare
Links: Report | RightCare press release
Date: 2013-Nov
A report examined the social determinants of health and the health divide in the World Health Organization European Region. The report made recommendations for reducing health inequalities across the life course in 53 countries. It was used to inform the development of the new European policy framework, Health 2020.
Source: UCL Institute of Health Equity, Review of Social Determinants and the Health Divide in the WHO European Region: Final report, World Health Organisation
Links: Report | Summary | WHO press release
Date: 2013-Nov
A report examined dementia care provision for people from black, Asian and minority-ethnic groups. It said that there was a growing body of evidence that the black African-Caribbean community in the United Kingdom had a higher prevalence of vascular dementia than other communities, and that prevalence of dementia in some communities had been significantly underestimated. It said that the existing dementia strategy should be implemented appropriately and the information and support needs of black and minority-ethnic communities met.
Source: David Truswell, Black, Asian and Minority Ethnic Communities and Dementia: Where are we now?, Race Equality Foundation
Date: 2013-Nov
A report examined the social and economic inequalities associated with diet and physical activity and suggested possible explanations for these inequalities.
Source: Kath Roberts, Nick Cavill, Caroline Hancock, and Harry Rutter, Social and Economic Inequalities in Diet and Physical Activity, Public Health England
Links: Report | PHE press release
Date: 2013-Nov
A report highlighted that those people within the criminal justice system, or at risk of offending, frequently suffered from multiple and complex health issues that were often exacerbated by difficulties in accessing health and social care services. The report called for healthcare providers and commissioners to improve understanding of health needs through using the available health data from criminal justice agencies in the Joint Strategic Needs Assessment process. The report also recommended utilizing existing partnership arrangements to co-ordinate this work and to explore ways in which joint commissioning might address multiple needs such as health and housing.
Source: Balancing Act: Addressing health inequalities among people in contact with the criminal justice system, Revolving Doors Agency
Links: Report | RDA press release
Date: 2013-Oct
A report examined the nature and extent of in-work poverty in Scotland and its implications for health. It noted fundamental shifts in patterns of work and a need to move away from dichotomous perspectives of 'employment or unemployment', 'employment or poverty' and 'employment or welfare dependency'. The implications of these changes were generally negative, with a detrimental impact on mental health and well-being. This would be compounded by changes to the United Kingdom welfare system, the resulting increased poverty rates and widened health inequalities. The report recommended a policy focus on the health impact of welfare reforms and further, more robust research on the dynamics of poverty and its impact on health.
Source: Chris Harkins and James Egan, The Rise of In-Work Poverty and the Changing Nature of Poverty and Work in Scotland: What are the implications for population health?, Glasgow Centre for Population Health
Links: Report
Date: 2013-Oct
A report examined health inequalities in Europe. It said that the financial crisis had widened inequalities in many European Union member states and continued to influence many of the key social determinants of health in Europe, both through changes to living conditions and to public spending.
Source: Jonathan Suk, Anastasia Pharris, Jan Semenza, Teymur Noori, Tek-Ang Lim, Andreas Sandgren, Irina Dinca, and Svetla Tsolova, Health Inequalities, the Financial Crisis, and Infectious Disease in Europe, European Centre for Disease Prevention and Control
Links: Report
Date: 2013-Oct
An article examined the promotion of behavioural change and healthy lifestyles as a central part of tackling health inequalities. This approach tended to place the responsibility for ill-health on individuals, rather than taking action on the social and relational determinants of health.
Source: Paul Crawshaw, 'Public health policy and the behavioural turn: the case of social marketing', Critical Social Policy, Volume 33 Issue 4
Links: Abstract
Date: 2013-Oct
A report highlighted health inequalities in Scotland. The report noted that there was a need to address underlying differences in income, wealth and power.
Source: Sonia Scott, Esther Curnock, Rory Mitchell, Mark Robinson, Martin Taulbut, Elaine Tod, and Gerry McCartney, What Would it Take to Eradicate Health Inequalities? Testing the fundamental causes theory of health inequalities in Scotland, NHS Health Scotland
Links: Report | NHS Health Scotland press release | BBC report
Date: 2013-Oct
A report examined health inequalities in the European Union. There had been some positive developments in implementing the EU strategy (2009) on health inequalities: but more action was needed at local, national, and EU levels. Overall life expectancy and infant mortality had improved: but health inequalities between social groups remained high and persistent, with an additional existing and future challenge due to the economic crisis.
Source: Report on Health Inequalities in the European Union, European Commission
Links: Report | EPHA press release
Date: 2013-Sep
An article examined changes in health and poverty dynamics simultaneously, using repeated measures of self-rated health and income for working-aged adults from the British Household Panel Survey. Concurrent and bidirectional longitudinal relationships were found between poverty and health, with non-employment appearing to mediate longitudinal health-to-poverty effects and confound longitudinal poverty-to-health effects.
Source: Amanda Sacker , Diana Worts, and Peggy McDonough, 'A multiple-process latent transition model of poverty and health', Methodology: European Journal of Research Methods for the Behavioral and Social Sciences, Volume 9 Number 4
Links: Abstract
Date: 2013-Sep
A think-tank report examined whether Sure Start children's centres were being used to their full potential. It said that local authorities needed to make better use of them to close the gap between rich and poor children. They should return children's centres to their original purpose and target their expenditure on more deprived areas, alongside increased financial transparency. The government should consider lowering the cap on parental income eligibility for tax-free childcare, and reinvest the money in time-limited seed funding that local authorities, early years providers or individual children's centres could bid for to raise the quality of childcare in deprived areas. Outcome-based measures should be developed for all children's centres.
Source: Harriet Waldegrave, Centres of Excellence? The role of children s centres in early intervention, Policy Exchange
Links: Report | Policy Exchange press release | Action for Children press release
Date: 2013-Sep
An article presented alternative longitudinal procedures designed to analyze the role of health determinants in driving changes in income-related health inequality through both morbidity changes and mortality, illustrated by an empirical analysis of the increase in income-related health inequality in Great Britain between 1999 and 2004.
Source: Paul Allanson and Dennis Petrie, 'Longitudinal methods to investigate the role of health determinants in the dynamics of income-related health inequality', Journal of Health Economics, Volume 32 Issue 5
Links: Abstract
Date: 2013-Sep
A report said that cuts of £1.5 billion to early intervention funding and a multitude of barriers were stopping many of those families most in need from using children's centres. Many disadvantaged families had very little knowledge of children's centres; a quarter of parents said that they found it difficult to access their local centre because of transport problems; and working parents often struggled to use centres because of their work commitments.
Source: Sam Royston and Laura Rodrigues, Breaking Barriers: How to help children s centres reach disadvantaged families, Children s Society
Links: Report | Childrens Society press release | Nursery World report
Date: 2013-Sep
A review examined inequities in health in Europe, in order to support the development of the new European policy framework for health and well-being. It made a series of recommendations for action to reduce health inequities: throughout life (in family building, childhood and the work place, and for women and older people); in wider society (action for social protection, on gender, in local communities, and against social exclusion); on the macro-level context (on social expenditure and for sustainable development); and on systems (to improve governance, to address health priorities, and to measure and report on progress against inequities in health).
Source: Michael Marmot et al., Review of Social Determinants and the Health Divide in the WHO European Region: Final Report, World Health Organisation (Regional Office for Europe)
Links: Report | WHO press release
Date: 2013-Sep
A paper examined the causal relationship between education and health outcomes in developed (OECD) countries. There was evidence that more years of education led to better health for a limited number of health markers. There were lower probabilities of reporting poor health, of having limitations in functional status, and of having been diagnosed with diabetes. There was no evidence of a causal effect of education on other health conditions. The relationship between education and cancer was positive, suggesting that education fostered early detection.
Source: Raquel Fonseca and Yuhui Zheng, The Effect of Education on Health: Cross-Country Evidence, Working Paper 13-25, Centre Interuniversitaire sur le Risque, les Politiques Economiques et l'Emploi (Universite du Quebec, Montreal, Canada)
Links: Paper
Date: 2013-Sep
An article examined which antecedent risk factors could explain the social patterning in hospital use in the west of Scotland. Overall admissions to hospital were only marginally socially patterned, and less than would be expected on the basis of the gradient in baseline risk. However, there was marked social patterning in admissions for mental health problems. Non-emergency hospital admissions were patterned inversely according to risk.
Source: Gerry McCartney, Carole Hart, and Graham Watt, 'How can socioeconomic inequalities in hospital admissions be explained? A cohort study', BMJ Open, Volume 3 Issue 8
Date: 2013-Aug
An article examined ethnic differentials in mortality in England and Wales. Immigrants, regardless of ethnicity, all had lower mortality than whites born in the United Kingdom. Indian, Pakistani, Bangladeshi, and Chinese immigrants had lower mortality than UK-born whites living in similar circumstances to them: but UK-born Black Caribbean people had higher mortality, due to their low socio-economic status. Immigrants were selected for good health, which had offset the impact of socio-economic disadvantage on the mortality of minority-ethnic groups. As the immigrant population aged and the UK-born minority-ethnic population grew, ethnic differentials in all-cause mortality were likely to change.
Source: Anne Scott and Ian Timaeus, 'Mortality differentials 1991-2005 by self-reported ethnicity: findings from the ONS Longitudinal Study', Journal of Epidemiology and Community Health, Volume 67 Number 9
Links: Abstract
Date: 2013-Aug
An article examined the role of socio-economic position in adolescent development in the areas of smoking, drinking, and psychiatric distress. Associations were evident in opposing directions or absent depending on the combination and timing of outcomes, suggesting that a disadvantaged socio-economic position was not a simple common cause for all three outcomes.
Source: Michael Green, Alastair Leyland, Helen Sweeting, and Michaela Benzeval, 'Socioeconomic position and adolescent trajectories in smoking, drinking, and psychiatric distress', Journal of Adolescent Health, Volume 53 Issue 2
Links: Abstract
Date: 2013-Aug
An article said that participants in the governance of health affairs in Scotland were making important contributions to the reduction of health inequality and the improvement of population health by: linking policy to address health inequality with policy to make healthcare, public health, social and housing services, and education more effective and efficient; linking policy to address the determinants of health with policy to stimulate economic growth and, as a result, increase employment and income; and embracing and applying research findings about the causes of deficiencies in population health status that contributed to health inequality.
Source: Daniel Fox, 'Health inequality and governance in Scotland since 2007', Public Health, Volume 127 Issue 6
Links: Abstract
Date: 2013-Jul
A paper said that nearly 80 per cent of people in England did not hit national physical activity government targets, and that there was evidence of a direct correlation between physical activity and people's education, their household income, and local area deprivation. Those with higher socio-economic status had increased levels of physical activity; adults who were degree-educated had a 12 per cent chance of being physically inactive, whereas those with no qualifications were three times as likely to be physically inactive.
Source: Lisa Farrell, Bruce Hollingsworth, Carol Propper, and Michael Shields, The Socioeconomic Gradient in Physical Inactivity in England, Working Paper 13/311, Centre for Market and Public Organisation (University of Bristol)
Links: Paper | Bristol University press release
Date: 2013-Jul
An article compared the effect of two methods of mobilization – doorstep canvassing and postal appeals – on family attendance at early childhood Sure Start centres in England. No evidence was found of a significant difference in attendance between different groups in the trial: neither visits nor leaflets were effective in encouraging non-attenders to go to Sure Start.
Source: Sarah Cotterill, Peter John, and Alice Moseley, 'Does mobilisation increase family engagement with an early childhood intervention programme? A randomised controlled trial', Policy & Politics, Volume 41 Number 2
Links: Abstract
Date: 2013-Jul
A report by an all-party group of MPs said that action was needed to improve the performance of Sure Start children's centres. It said that children's centres should measure and compare outcomes for the children and families they worked with over the longer term, at least until the point that children started school. Local authorities should monitor the relative performance of children's centres in their area, and share information on best practice.
Source: Best Practice for a Sure Start: The way forward for children's centres, All Party Parliamentary Sure Start Group
Links: Report | Action for Children press release | Voice press release
Date: 2013-Jul
A report presented findings from the first wave of detailed fieldwork regarding the organization and delivery of children's centre services. This fieldwork aimed to assess: the range of activities and services that centres delivered; partnership working methods; leadership and management; evidence-based practice; and area profiling of centre 'reach'. Children's centres were increasingly targeting services at disadvantaged families, and broadening their geographical reach.
Source: Jenny Goff, James Hall, Kathy Sylva, Teresa Smith, George Smith, Naomi Eisenstadt, Pam Sammons, Maria Evangelou, Rebecca Smees, and Kityu Chu, Evaluation of Children s Centres in England (ECCE) Strand 3: Delivery of Family Services by Children s Centres, Research Report 297, Department for Education
Links: Report | Brief | Action for Children press release | Children & Young People Now report
Date: 2013-Jul
A think-tank report highlighted unacceptable inequalities in end-of-life care. The single biggest difference was whether someone was dying from cancer – despite accounting for only 27 per cent of all deaths, cancer sufferers made up around 90 per cent of users of hospice care. The report called for a series of reforms to prevent future inequalities, so that there was no longer a 'lottery' based on arbitrary factors such as disease, age, background, and location. Achieving this required a patient-driven, personalized approach, which would give people more control over their care.
Source: Ally Paget and Claudia Wood, Ways and Means, Demos
Links: Report | Summary | Demos press release | Community Care report | Telegraph report
Date: 2013-Jun
An article examined the proposition (set out in the book The Spirit Level) that inequality was associated with high levels of obesity. It reviewed existing literature and used British Household Panel Survey data to study how district-level and regional-level income inequality was related to obesity. 'Little evidence' was found to support policies that reduced income inequality with the aim of reducing obesity levels.
Source: Darshan Zala, 'Challenging The Spirit Level: is there really a relationship between inequality and obesity?', Economic Affairs, Volume 33 Issue 2
Links: Abstract
See also: Richard Wilkinson and Kate Pickett, The Spirit Level: Why equality is better for everyone, Penguin (2010)
Date: 2013-Jun
A report said that significantly more of those responding on behalf of patients living in the least deprived areas rated the standard of overall end-of-life care as excellent (44 per cent) compared with those for patients living in the most deprived areas (39 per cent). Patients in the least deprived areas were more likely to be treated with dignity and respect from services received in the community (district and community nurses and family doctors) compared with patients in the most deprived areas.
Source: National Bereavement Survey (VOICES) by Area Deprivation, 2011, Office for National Statistics
Links: Report | NCPC press release | Guardian report
Date: 2013-Jun
An article examined the impact of unemployment on limiting long-term illness, mental health problems, and mortality in north and south England. Unemployment was estimated to be causing 1,145 deaths per year, 221,020 cases of mental health problems, and 275,409 cases of limiting long-term illness in England. Rates of all three were distinctively higher in the north compared with the south. Considering hidden unemployment in the calculations considerably increased the proportion of women suffering from ill-health due to unemployment.
Source: Holger Moller, Fiona Haigh, Chris Harwood, Tony Kinsella, and Daniel Pope, 'Rising unemployment and increasing spatial health inequalities in England: further extension of the north-south divide', Journal of Public Health, Volume 35 Number 2
Links: Abstract
Date: 2013-May
An article examined social inequalities in obesity in 11 OECD countries, including England. Large and persistent social inequalities in obesity and overweight by education level and socio-economic status were found. These were consistently larger in women than in men.
Source: Marion Devaux and Franco Sassi, 'Social inequalities in obesity and overweight in 11 OECD countries', European Journal of Public Health, Volume 23 Issue 3
Links: Abstract
Date: 2013-May
A report compared early years and childhood experiences in Scotland and England. It considered social and material circumstances; dysfunctional households; maternal and child health; and parenting. Little evidence was found of differences that could explain the relatively poor health status of people in Scotland.
Source: Martin Taulbut and David Walsh, Poverty, Parenting and Poor Health: Comparing early years experiences in Scotland, England and three city regions, Glasgow Centre for Population Health
Links: Report
Date: 2013-May
A paper examined the causal effect of family income on child health in the United Kingdom. There was evidence that income had a small but significant causal effect on subjective child health. Parental health did not drive a spurious relationship between family income and child health, as some had argued. No significant effects were found of family income on chronic indicators of child health.
Source: Daniel Kuehnle, The Causal Effect of Family Income on Child Health: A re-examination using an instrumental variables approach, Discussion Paper 133, Bavarian Graduate Program in Economics
Links: Paper
Date: 2013-Apr
An article said that each year 5,600 people in England missed out on having their cancer diagnosed at an earlier stage because of social inequalities. Patients living in poorer neighbourhoods in eastern England were less likely to have their cancers picked up early than those living in more affluent parts of the region.
Source: Georgios Lyratzopoulos, Gary Abel, Clement Brown, Brian Rous, Sally Vernon, Martin Roland, and David Greenberg, 'Socio-demographic inequalities in stage of cancer diagnosis: evidence from patients with female breast, lung, colon, rectal, prostate, renal, bladder, melanoma, ovarian and endometrial cancer', Annals of Oncology, Volume 24 Number 3
Links: Abstract | Cambridge University press release | BBC report
Date: 2013-Apr
A study examined whether the way in which deprived and affluent areas were distributed across the city of Glasgow (Scotland), compared with English cities, might adversely affect the health of Glasgow's population. It was concluded that although spatial patterning might have a small influence on neighbourhood mortality rates, it did not explain differences between Glasgow and other cities. The most significant explanatory variable was deprivation, although the relationship between deprivation and mortality rates was different in the three cities.
Source: Mark Livingston, David Walsh, Bruce Whyte, and Nick Bailey, Investigating the Impact of the Spatial Distribution of Deprivation on Health Outcomes, Glasgow Centre for Population Health
Links: Report
Date: 2013-Apr
A report provided findings from a survey of families who were using Sure Start children's centres when their child was 9-18 months of age (as part of a larger evaluation of children's centres in England). Satisfaction with services and activities was generally very high: just under half of parents (49 per cent) said that they were 'very satisfied' and a further 29 per cent said that they were 'fairly satisfied'. For each of the 22 service categories, the majority of users considered them to be 'very helpful'; and the proportion of users who rated them as 'very' or 'fairly helpful' ranged from 88 per cent to 100 per cent.
Source: Ruth Maisey, Svetlana Speight, and Sarah Haywood, with James Hall, Pamela Sammons, David Hussey, Jenny Goff, Maria Evangelou, and Kathy Sylva, Evaluation of Children s Centres in England (ECCE) Strand 2: Baseline Survey of Families Using Children s Centres in the Most Disadvantaged Areas, Research Report 260, Department for Education
Date: 2013-Apr
A report examined the health status of people in Europe facing multiple vulnerability factors. It called national public health systems to be built on solidarity, equality, and equity, and open to all those living in the European Union, rather than systems based on a profit rationale.
Source: Pierre Chauvin, Nathalie Simonnot, and Frank Vanbiervliet, Access to Healthcare in Europe in Times of Crisis and Rising Xenophobia: An overview of the situation of people excluded from healthcare systems, Doctors of the World (Medecins du Monde)
Links: Report | EPHA press release
Date: 2013-Apr
An article examined changes in the associations between socio-economic status and birthweight and gestational age in a northern city (Newcastle upon Tyne) during the period 1961-2000. It was found that there had been no improvement in socio-economic inequalities in birthweight and pre--term birth over four decades:
Source: Svetlana Glinianaia, Rakesh Ghosh, Judith Rankin, Mark Pearce, Louise Parker, and Tanja Pless-Mulloli, 'No improvement in socioeconomic inequalities in birthweight and preterm birth over four decades: a population-based cohort study', BMC Public Health, Volume 13
Date: 2013-Apr
An article examined whether minority-ethnic people were less likely than the white population to receive treatment for mental health problems, controlling for symptom severity. Interventions to reduce these inequalities were needed to ensure that National Health Service healthcare was delivered fairly to all ethnic groups according to need.
Source: Claudia Cooper, Nicola Spiers, Gill Livingston, Rachel Jenkins, Howard Meltzer, Terry Brugha, Sally McManus, Scott Weich, and Paul Bebbington, 'Ethnic inequalities in the use of health services for common mental disorders in England', Social Psychiatry and Psychiatric Epidemiology, Volume 48 Number 5
Links: Abstract
Date: 2013-Apr
A report said that the healthcare system and those working within it had an important and often under-utilized role in reducing health inequalities through action on the social determinants of health.
Source: Matilda Allen, Jessica Allen, and Sue Hogarth (with Michael Marmot), Working for Health Equity: The role of health professionals, Institute of Health Equity (University College, London)
Links: Report | Summary | CSP press release | NHS Alliance press release | RCN press release | BBC report
Date: 2013-Mar
An article examined the social value judgements about equity in health and healthcare that the National Institute for Health and Clinical Excellence had hitherto used to guide its decision making.
Source: Koonal Shah, Richard Cookson, Anthony Culyer, and Peter Littlejohns, 'NICE's social value judgements about equity in health and health care', Health Economics, Policy and Law, Volume 8 Issue 2
Links: Abstract
Date: 2013-Mar
A report examined the unequal access to healthcare that people in Europe might face because of a combination of their characteristics, such as ethnic origin, gender, age, and disability. In such cases, people and their legal advisors often had difficulty bringing a complaint of discrimination on 'multiple' grounds to court. This was either because of a poor understanding of multiple discrimination, or because legally it was simply easier to deal with a complaint on only one particular ground.
Source: Inequalities and Multiple Discrimination in Access to and Quality of Healthcare, European Agency for Fundamental Rights
Links: Report | FRA press release
Date: 2013-Mar
A study found that people with learning disabilities were more likely to die from causes that could have been prevented by good healthcare than other people. Learning disabled people died more than 16 years earlier than other people, on average, in part because of inadequate healthcare and unequal access to services.
Source: Pauline Heslop, Peter Blair, Peter Fleming, Matt Hoghton, Anna Marriott, and Lesley Russ, Confidential Inquiry into Premature Deaths of People with Learning Disabilities (CIPOLD): Final report, Norah Fry Research Centre (University of Bristol)
Links: Report | Summary | Bristol University press release | Mencap press release | BBC report | Community Care report | Guardian report | Telegraph report
Date: 2013-Mar
An article examined whether it would be possible to bring about more equality in health by equalizing status. It said that there were (at least some) prima facie reasons to counter (at least some) status inequalities in order to equalize health.
Source: Morten Ebbe Juul Nielsen, 'Should we equalize status in order to equalize health?', Public Health Ethics, Volume 6 Issue 1
Links: Abstract
Date: 2013-Mar
An article examined the relationship between the practice of healthy lifestyles and the prevailing living circumstances of black and other visible minority-ethnic communities. Black participants in the study believed that principles of healthy lifestyles were largely not relevant to their lived experiences because they failed to take into account their experiences of racism, social exclusion, ethnic identity, values, and beliefs.
Source: Bertha Ochienga, 'Black families perceptions of barriers to the practice of a healthy lifestyle: a qualitative study in the UK', Critical Public Health, Volume 23 Number 1
Links: Abstract
Date: 2013-Mar
A paper examined the extent to which health economics literature in Europe using standardized cross-country health inequality indexes was subject to methodological and publication biases.
Source: Joan Costa-Font and Cristina Hernandez-Quevedo, Inequalities in Self-Reported Health: A meta-regression analysis, Working Paper 32/2013, LSE Health (London School of Economics)
Links: Paper
Date: 2013-Mar
An article examined why socio-economic variations in health had continued to widen in England, despite the fact that tackling them had became a key policy objective. The health problems facing England's most deprived areas, and the solution to those problems, had increasingly come to be linked to levels of National Health Service funding. This 'medicalization' of the issue focused attention on the role of individual risk factors that lent themselves to medical management, but effectively sidelined the 'macroprocesses' of social inequality, legitimizing a neo-liberal view of health as a matter of individual rather than collective responsibility.
Source: Sheena Asthana, Alex Gibson, and Joyce Halliday, 'The medicalisation of health inequalities and the English NHS: the role of resource allocation', Health Economics, Policy and Law, Volume 8 Issue 2
Links: Abstract
Date: 2013-Mar
A new book examined the extent of inequalities in health in the UK and USA, describing it as the 'scandal of our times'. The gaps in life expectancy between regions, between cities, and between neighbourhoods within cities surpassed the worst measures over the previous hundred years.
Source: Danny Dorling, Unequal Health: The scandal of our times, Policy Press
Links: Summary
Date: 2013-Mar
An article examined differences in socio-economic status in common mental disorders and use of psychotherapy. Higher socio-economic status was associated with lower odds of common mental disorder and of being treated by publicly provided psychotherapy, but higher odds of being a client of private psychotherapy. The use of publicly provided psychotherapy had improved between 1991 and 2009 among those with low socio-economic status, but social inequalities in common mental disorders remained.
Source: Markus Jokela, David Batty, Jussi Vahtera, Marko Elovainio, and Mika Kivimaki, 'Socioeconomic inequalities in common mental disorders and psychotherapy treatment in the UK between 1991 and 2009', British Journal of Psychiatry, Volume 202 Issue 2
Date: 2013-Feb
An article examined how the organization of policy-making bodies shaped the relationship between research and policy, using health inequalities in England as a case study. Policy 'silos' and hierarchies worked as filters to research-based ideas, encouraging those ideas that supported existing institutionalized ideas (or 'policy paradigms'), while blocking or significantly transforming more challenging ideas. This limited the extent to which research could inform policy. But a lack of institutional memory within policy-making enabled recycled ideas to appear innovative, creating an impression of meaningful, ongoing dialogue between research and policy.
Source: Katherine Smith, 'Institutional filters: the translation and re-circulation of ideas about health inequalities within policy', Policy & Politics, Volume 41 Number 1
Links: Abstract
Date: 2013-Feb
A paper used data from the British Household Panel Survey to analyze changes in poverty of self-reported health from 1991 to 2008. The health poverty rate increased independently of the health poverty threshold chosen. The most important poverty-increasing factors included a rise of both the health poverty and population shares of people cohabiting and couples with no children, as well as an increase of the population of retired people.
Source: Michal Brzezinski, Accounting for Trends in Health Poverty: A decomposition analysis for Britain, 1991–2008, Working Paper 2/2013, Faculty of Economic Sciences, University of Warsaw (Poland)
Links: Paper
Notes: The health poverty rate was defined as the share of population with poor or fair health.
Date: 2013-Feb
An article examined the associations between socio-economic position in early life and later alcohol use (and problem use) among adolescents in England. Children from higher-income households appeared to be at greater risk of some types of adolescent alcohol problems, and these risks appeared different in girls compared with boys. Childhood social advantage might not generally be associated with healthier behaviour in adolescence.
Source: Roberto Melotti, Glyn Lewis, Matthew Hickman, Jon Heron, Ricardo Aray, and John Macleod, 'Early life socioeconomic position and later alcohol use: birth cohort study', Addiction, Volume 108 Issue 3
Links: Abstract
Date: 2013-Feb
An article examined the evidence for links between the provision of advice services and improvements in health.
Source: Peter Allmark, Susan Baxter, Elizabeth Goyder, Louise Guillaume, and Gerard Crofton-Martin, 'Assessing the health benefits of advice services: using research evidence and logic model methods to explore complex pathways', Health and Social Care in the Community, Volume 21 Issue 1
Links: Abstract
Date: 2013-Feb
An article examined whether hospital competition undermined socio-economic equity in the utilization of healthcare. A negative association was found between market competition and elective admissions in deprived areas. However, the authors point out that the effect of pro-competition reform had been to reduce this negative association slightly, 'suggesting that competition did not undermine equity'.
Source: Richard Cookson, Mauro Laudicella, and Paolo Li Donni, 'Does hospital competition harm equity? Evidence from the English National Health Service', Journal of Health Economics, Volume 32 Issue 2
Links: Abstract
Date: 2013-Feb
An article examined how the general public 'traded off' the sometimes competing objectives of a cost-benefit allocation of health resources (on the one hand) and reducing health inequalities (on the other). One extra year of life in full health to someone who would otherwise die at the age of 60 years was worth more than twice as much as an additional year of life to someone who would otherwise die at the age of 70 years. These results could help inform the rationing decisions faced by all healthcare systems.
Source: Paul Dolan and Akil Tsuchiya, 'It is the lifetime that matters: public preferences over maximising health and reducing inequalities in health', Journal of Medical Ethics, Volume 38 Number 9
Links: Abstract
Date: 2013-Feb
A study found that home equity had a strong impact on individual health. Home equity lowered the likelihood of home-owners exhibiting a broad range of medical conditions. This was due to increased use of private healthcare, reduced hours of work, and increased exercise. Home equity, unlike income, did not increase risky health behaviours such as smoking and drinking. The positive health effects of home equity gains on home-owner health over the business cycle offset the negative effects of labour market conditions and work intensity.
Source: Eleonora Fichera and John Gathergood, House Prices, Home Equity and Health, Working Paper 13/01, Health Economics Resource Centre, University of York
Links: Paper
Date: 2013-Jan
A new book examined whether social capital influenced health and health inequalities in European welfare states.
Source: Mikael Rostila, Social Capital and Health Inequality in European Welfare States, Palgrave Macmillan
Links: Summary
Date: 2013-Jan
A paper examined differences between the United Kingdom and Sweden in the association between parental income and certain education and health/developmental outcomes.
Source: Anders Bjorklund Markus and Jantti Martin Nybom, The Role of Parental Income over the Life Cycle: A comparison of Sweden and the UK, Discussion Paper 7066, Institute for the Study of Labor (Bonn)
Links: Paper
Date: 2013-Jan
A paper examined the implications of consumer heterogeneity for whether competition would improve outcomes in healthcare markets. Competition generally favoured the majority group, as higher quality for the majority was an effective way to increase the 'quality signal' and attract patients. A regulator concerned about equity might protect the minority group by not introducing competition. Alternatively, if the minority group were favoured by the providers under monopoly, competition could improve equity by forcing the providers to increase quality for the majority group.
Source: Maija Halonen-Akatwijuka and Carol Propper, Competition, Equity and Quality in Health Care, Working Paper 12/296, Centre for Market and Public Organisation (University of Bristol)
Links: Paper
Date: 2013-Jan
An article examined how the health of children in different family types varied, and the extent to which any differences might be explained by poverty. Poor physical and mental health was slightly more prevalent in children living in lone-parent or reconstituted families. Poverty reduction might help to reduce these differences, especially for children living with lone parents: however, alternative mechanisms should be also explored, particularly for children living in reconstituted families.
Source: Anna Pearce, Hannah Lewis, and Catherine Law, 'The role of poverty in explaining health variations in 7-year-old children from different family structures: findings from the UK Millennium Cohort Study', Journal of Epidemiology and Community Health, Volume 67 Number 2
Links: Abstract
Date: 2013-Jan
A report by a committee of the Northern Ireland Assembly made a series of recommendations aimed at tackling health inequalities.
Source: Review of Health Inequalities, Northern Ireland Assembly Committee for Health, Social Services & Public Safety
Links: Report | NIA press release
Date: 2013-Jan
