A report examined the cost impact of earlier diagnosis in cancer treatment services for four types of cancer (colon, rectal, non-small cell lung, and ovarian). It said that there were marked variations in early diagnosis across England and that significant savings could be realized if all clinical commissioning groups (CCGs) were able to achieve the level of early diagnosis of the best. The report made a range of recommendations, including that earlier diagnosis should be viewed as an efficiency as well as a quality priority for the National Health Service, and that all CCGs and local health and well-being boards should set out plans to encourage this.
Source: Incisive Health, Saving Lives, Averting Costs: An analysis of the financial implications of achieving earlier diagnosis of colorectal, lung and ovarian cancer, Cancer Research UK
Links: Report | CRUK press release
Date: 2014-Sep
A series of reports and briefings summarized evidence, practical points, and case studies on approaches and actions that might be taken by local authorities on a range of issues to reduce health inequalities (drawing on expertise from the Marmot Review). Reports covered: parenting programmes; home to school transition; pupils' resilience in school; reducing the number of young people not in employment, education, or training; adult learning; increasing employment for older people and people with disabilities; improving workplace health; the living wage; fuel poverty; home-related health problems; access to green spaces; and the economics of investing in social determinants of health.
Source: Local Action on Health Inequalities: Introduction to a series of evidence papers, Public Health England
Links: Overarching report | Themed reports
Date: 2014-Sep
A report examined the relationship between faith and health, and the role of faith communities in improving health and reducing health inequalities in the United Kingdom.
Source: Lucy November, The Impact of Faith-Based Organisations on Public Health and Social Capital, Faith Action
Date: 2014-Sep
A report provided findings from an inquiry that examined health inequalities affecting the north of England. The report said that inequalities were caused by differences in poverty, power, and resources and their associated consequences for health, which had been worsened as a result of local authority cuts and welfare reforms that had an uneven impact in different areas of the country. Recommendations to address inequalities included measures to: address poverty and economic inequality within the north and between the north and the rest of England (including better housing, health equity strategies, and a living wage); promote healthy development in early childhood; share power over resources and increase the influence of the general public (including a call for devolution of responsibilities); and strengthen the role of the health sector in promoting health equity.
Source: Inquiry Panel on Health Equity for the North of England, Due North: Report of the Inquiry on Health Equity for the North, University of Liverpool/Centre for Local Economic Strategies
Links: Report | Summary | CLES press release | University of Durham press release
Date: 2014-Sep
A report said that of the three-year-old children in England whose parents gave consent for their participation in a survey 12 per cent had experienced dental decay, with wide regional variation in the prevalence and severity of decay.
Source: Oral Health Survey of Three-Year-Old Children 2013: A report on the prevalence and severity of dental decay, Public Health England
Links: Report | PHE press release | BBC report | Guardian report | Telegraph report
Date: 2014-Sep
An article examined the knowledge and beliefs of public policymakers on social inequalities in health, and policies to reduce such inequalities, in 13 European cities including London, England. It said that health inequalities were perceived by most policymakers as differences in life expectancy between populations with economic, social, and geographical differences, and that addressing inequalities was a key priority, but the main barriers were thought to be bureaucracy, funding, and population beliefs. The article called for further research on effective universal policies (including evaluation), and training for policymakers and officers on health inequalities.
Source: Joana Morrison, Mariona Pons-Vigues, Laia Becares, Bo Burstrom, Ana Gandarillas, Felicitas Dominguez-Berjon, Elia Diez, Giuseppe Costa, Milagros Ruiz, Hynek Pikhart, Chiara Marinacci, Rasmus Hoffmann, Paula Santana, Carme Borrell, and others, 'Health inequalities in European cities: perceptions and beliefs among local policymakers', BMJ Open, Volume 4 Issue 5
Links: Article
Date: 2014-Aug
A report examined inequalities in access to a range of surgical procedures across clinical commissioning group areas in England, examining CCG policy as compared with clinical guidance. It found a range of approaches and said that in two types of procedure in particular (hip replacement and inguinal hernia repair) there were relatively low levels of compliance with clinical guidance and/or no policy in place in over 70 per cent of areas. The report raised concern that there was no clinical justification for many of the policies discussed in the report, which left them at risk of legal challenge. The report made a number of recommendations.
Source: Is Access to Surgery a Postcode Lottery?, Royal College of Surgeons in England
Links: Report | RCS press release | Guardian report
Date: 2014-Jul
An article examined social innovations in addressing health inequalities in the United Kingdom. It discussed three forms of existing social innovation (microcredit for enterprise; social enterprise in the form of Work Integration Social Enterprises; and Self Reliant Groups) and said that, although certain innovations may have the potential to address health inequalities, there was a lack of large scale, high quality empirical evidence to inform understanding of success or to demonstrate impact.
Source: Michael Roy, Neil McHugh, and Clementine Hill O'Connor, 'Social innovation: worklessness, welfare and well-being', Social Policy and Society, Volume 13 Issue 3
Links: Abstract
Date: 2014-Jun
An article examined the role of social factors in healthy ageing in developed (OECD) countries, using a longevity index of centenarians. It said that governments needed to strengthen their preventive social programmes and increase their existing support services for the elderly through increased financing of the health sector.
Source: Jong In Kim, 'Association between social factors of health ageing and longevity: determinants of the longevity index (LI) in OECD countries', Ageing International, Volume 39 Number 2
Links: Abstract
Date: 2014-Jun
An article examined the relative association of social class and neighbourhood deprivation with primary health care consultations for eight conditions among patients aged over 50 years. It said that lower social class was associated with diabetes and chronic obstructive pulmonary disease, indicating the importance of identifying and acting on neighbourhood deprivation to reduce health inequalities.
Source: Kelvin Jordan, Richard Hayward, Eyitope Roberts, John Edwards, and Umesh Kadam, 'The relationship of individual and neighbourhood deprivation with morbidity in older adults: an observational study', European Journal of Public Health, Volume 24 Number 3
Links: Abstract
Date: 2014-Jun
A paper examined differences in self-reported health between the lowest and the highest income groups across Europe, drawing on data from the European Social Survey for 29 countries. It said that income-related health inequalities were found in all countries, with larger relative inequalities among men observed in Greece, Kosovo, Ireland, Israel, Iceland, and Slovenia, and among women in Lithuania, Denmark, Norway, Portugal, Cyprus, and Czech Republic.
Source: Olena Tigova, Income-Related Inequalities in Self-Reported Health across 29 European Countries: Findings from the European Social Survey, Centre for Health Equity Studies (Stockholm University)
Links: Paper
Date: 2014-Jun
An article examined the associations between (on the one hand) socio-demographic, psychosocial, material, and occupational factors and (on the other) self-reported health in the European working population.
Source: Stefanie Schutte, Jean-Francois Chastang, Agnes Parent-Thirion, Greet Vermeylen, and Isabelle Niedhammer, 'Association between socio-demographic, psychosocial, material and occupational factors and self-reported health among workers in Europe', Journal of Public Health, Volume 36 Number 2
Links: Abstract
Date: 2014-Jun
An article examined whether the policy of increasing National Health Service funding to a greater extent in deprived areas in England (compared with more affluent areas) led to a reduction in geographical inequalities in mortality amenable to healthcare. It concluded that, between 2001 and 2011, increased resources were associated with a reduction in absolute health inequalities, and that ending this policy may widen inequalities.
Source: Ben Barr, Clare Bambra, and Margaret Whitehead, 'The impact of NHS resource allocation policy on health inequalities in England 2001-11: longitudinal ecological study', BMJ, Volume 348
Links: Article
Date: 2014-Jun
A report examined the prevalence of mental health conditions and intellectual disability in the United Kingdom, their relationship with physical health, and the actions needed to reduce disparities in morbidity and mortality among the group of people with such conditions, compared with the rest of the population. It called for a range of changes, including: a national mortality review system; better prevention and early intervention strategies for mental health; enhanced training and workforce planning to improve the quality of care; more joined-up care, particularly through improving commissioning and delivery processes; and greater research focus on mental-physical multi-morbidity.
Source: Recognising the Importance of Physical Health in Mental Health and Intellectual Disability: Achieving parity of outcomes, British Medical Association
Links: Report | BMA press release | RCPsych press release
Date: 2014-May
A report examined the prevalence of mental health conditions and intellectual disability in the United Kingdom, their relationship with physical health, and the actions needed to reduce disparities in morbidity and mortality among the group of people with such conditions, compared with the rest of the population. It called for a range of changes, including: a national mortality review system; better prevention and early intervention strategies for mental health; enhanced training and workforce planning to improve the quality of care; more joined-up care, particularly through improving commissioning and delivery processes; and greater research focus on mental-physical multi-morbidity.
Source: Recognising the Importance of Physical Health in Mental Health and Intellectual Disability: Achieving parity of outcomes, British Medical Association
Links: Report | BMA press release | RCPsych press release
Date: 2014-May
A paper examined the existing evidence on sex workers in the United Kingdom, particularly in relation to health and social exclusion. It said that the effects differed according to the type of sex work but, in general terms, high levels of multiple social exclusion drove entrance into sex work, brought consequences such as poor health and homelessness, and created barriers for those wanting to change or stabilize their lives.
Source: Reuben Balfour and Jessica Allen, A Review of the Literature on Sex Workers and Social Exclusion, Institute of Health Equity (University College, London)
Links: Report
Date: 2014-Apr
An article examined published studies of social and health policies or interventions to tackle health inequalities in European cities, based on a scoping review. It said that, although health behaviours were not the main determinants of health inequalities, they were the focus of the majority of studies in the review.
Source: Mariona Pons-Vigues, Elia Diez, Joana Morrison, Sergio Salas-Nicas, Rasmus Hoffmann, Bo Burstrom, Jitse van Dijk, and Carme Borrell, 'Social and health policies or interventions to tackle health inequalities in European cities: a scoping review', BMC Public Health, Volume 14
Links: Abstract
Date: 2014-Apr
A report summarized key findings from the first phase of the Routes from Diagnosis research programme, which examined what happened to people in England with one of four cancer types (breast, prostate, lung, or brain/central nervous system cancer) after they were diagnosed. It said that there was a large variation in survival and the long-term impact on survivors' health for the different forms of cancer. Recommendations included: improving early diagnosis; providing equal access to the best available treatment, regardless of age or geographical location; and implementing the 'cancer recovery package'.
Source: Cancer's Unequal Burden: The reality behind improving cancer survival rates, Macmillan
Links: Report | Macmillan press release
Date: 2014-Apr
An article examined the Well London programme, a multicomponent community engagement and coproduction programme designed to improve the health of Londoners living in socio-economically deprived neighbourhoods. It examined, in particular, the nature of the benefits to residents and the processes by which these were achieved.
Source: Jane Derges, Angela Clow, Rebecca Lynch, Sumeet Jain, Gemma Phillips, Mark Petticrew, Adrian Renton, and Alizon Draper, '"Well London" and the benefits of participation: results of a qualitative study nested in a cluster randomised trial', BMJ Open, Volume 4 Number 4
Date: 2014-Apr
An article examined the implications of long-term inequality exposure for older people's physical health, drawing on data for 16 developed (OECD) countries including England. Exposure to higher average long-term levels of inequality was significantly negatively related to objectively measured grip strength and lung function, but unrelated to self-reported limitations (although increasing inequality over time was positively related to self-reported limitations). The grip strength and lung function associations were partially explained by between-country differences in height, and in the latter case this factor may fully account for the apparent effect of inequality.
Source: Robert de Vries, David Blane, and Gopalakrishnan Netuveli, 'Long-term exposure to income inequality: implications for physical functioning at older ages', European Journal of Ageing, Volume 11 Number 1
Links: Abstract
Date: 2014-Mar
A report examined the data available on the health of four vulnerable and excluded groups: vulnerable migrants; Gypsies and Travellers; homeless people; and sex workers. It said that it was difficult to obtain a comprehensive national or local level picture of health needs for people in these groups because they did not generally appear within the datasets that were used for measuring and monitoring access to healthcare. The report discussed the gaps in data and made recommendations for action, noting a need for partnership between Public Health England, NHS England, government departments, the Health and Social Care Information Centre, and the third sector.
Source: Peter Aspinall, Hidden Needs – Identifying Key Vulnerable Groups in Data Collections: Vulnerable migrants, Gypsies and Travellers, homeless people, and sex workers, National Inclusion Health Board
Links: Report
Date: 2014-Mar
A report examined the association between income and health, through a systematic review of the English language literature relating to countries within the Organisation for Economic Co-operation and Development. It said that existing research suggested four main ways in which money affected outcomes: material (money bought goods and services that improved health); psychosocial (managing a low-income was stressful, causing biochemical changes in the body that affected health); behavioural (people on low incomes were more likely to adopt unhealthy behaviours for a variety of reasons, while those on higher incomes were more able to afford healthier lifestyles); and reverse causation (where poor health led to low income). The report concluded that the pathways interacted in multiple ways to influence health, such that broad-ranging policies were required to address health inequalities.
Source: Michaela Benzeval, Lyndal Bond, Mhairi Campbell, Mathew Egan, Theo Lorenc, Mark Petticrew, and Frank Popham, How Does Money Influence Health?, Joseph Rowntree Foundation
Date: 2014-Mar
An article examined working-class men's perceptions and experiences regarding gender differences in health. Men put forward a range of behavioural/cultural, materialist/structural, and psychosocial factors, which were believed to have different impacts on their health compared with women's.
Source: Alan Dolan, '"Men give in to chips and beer too easily": how working-class men make sense of gender differences in health', Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, Volume 18 Number 2
Links: Abstract
Date: 2014-Mar
A report provided results from research on the impact of the economic downturn and policy changes on health inequalities in London. An earlier report had provided a synthesis of evidence on the potential impacts, and this report described a set of indicators that had been subsequently developed and tested, to provide a common framework to monitor and respond to the effects of the downturn and welfare and other policy changes.
Source: Gail Findlay, Mark Gamsu, and Angela Donkin, The Impact of the Economic Downturn and Policy Changes on Health Inequalities in London: Development of an indicator set, Institute of Health Equity (University College, London)
Links: Report | Summary | Synthesis report
Date: 2014-Mar
An article examined the hypothesis that minority-ethnic people resident in neighbourhoods with lower ethnic density did not access health services because of fear of racial discrimination. It was found that health-seeking behaviour did not vary by ethnic density. Lower ethnic density was associated with increased reports of expected discrimination from services, but also with increased satisfaction with services.
Source: Laia Becares and Jayati Das-Munshi, 'Ethnic density, health care seeking behaviour and expected discrimination from health services among ethnic minority people in England', Health and Place, Volume 22
Links: Abstract
Date: 2014-Feb
An article examined mortality inequality within Great Britain, comparing England and Wales with Scotland for the period 1925-2005. Inequalities in mortality had became more apparent over time, and affected young Scottish men most severely after 1995. It said that something dramatic appeared to have happened to the Scottish population in the early 1970s that had accelerated these differentials.
Source: Malcolm Campbell, Dimitris Ballas, Daniel Dorling, and Richard Mitchell, 'Mortality inequalities: Scotland versus England and Wales', Health and Place, Volume 20
Links: Abstract
Date: 2014-Feb
An article examined how age-specific inequalities in mortality rates in England had changed over the previous decade, during a time of widening health inequalities. Evidence was found for equalization, with a clear decline in the ratio of mortality rates during late adolescence. However this decline was not accounted for by traditional explanations. Overall, geographical inequalities were shown to be widening for the majority of ages.
Source: Mark Green, 'The equalisation hypothesis and changes in geographical inequalities of age based mortality in England, 2002-2004 to 2008-2010', Social Science & Medicine, Volume 87
Links: Abstract
Date: 2014-Feb
An article examined the relationship between neighbourhood housing tenure mix and health outcomes for urban residents in Scotland. It said there was no consistent pattern in health outcomes according to housing tenure mix but, for some specific health issues, neighbourhood type was associated with worse outcomes.
Source: Richard Lawder, David Walsh, Ade Kearns, and Mark Livingston, 'Healthy mixing? Investigating the associations between neighbourhood housing tenure mix and health outcomes for urban residents', Urban Studies, Volume 51 Number 2
Links: Abstract
Date: 2014-Feb
An article examined how the impact of retirement on self-assessed illness varied spatially. The rise in illness rates with age slowed or declined at retirement age, indicating possible health improvement after retirement. The effect was negligible in the affluent south-east region and most prominent in the coalfield and former industrial districts. It was attributable to hidden unemployment and health-related selective migration, but additionally in certain areas retirement was associated with improvements in self-assessed health.
Source: Alan Marshall and Paul Norman, 'Geographies of the impact of retirement on health in the United Kingdom', Health and Place, Volume 20
Links: Abstract
Date: 2014-Feb
An article examined socio-economic inequalities in health-related consumption patterns. Lower-income groups generally purchased a greater proportion of energy from less healthy foods and beverages than those in higher-income groups. At the nutrient-level, socio-economic differences were less marked.
Source: Rachel Pechey, Susan Jebb, Michael Kelly, Eva Almiron-Roig, Susana Conde, Ryota Nakamura, Ian Shemilt, Marc Suhrcke, and Theresa Marteau, 'Socioeconomic differences in purchases of more vs. less healthy foods and beverages: analysis of over 25,000 British households in 2010', Social Science & Medicine, Volume 92
Links: Abstract
Date: 2014-Feb
A report examined inequalities and inequities in access to health services in Wales and the United Kingdom that were associated with characteristics of gender, sexual identity, and gender reassignment. While noting many points at which inequalities and inequities arose, the report said that much of the evidence came from small scale studies that raised issues regarding generalization. It recommended a full review across all of the groups protected by the Equalities Act 2010, and for further work to establish existing areas of intervention and good practice.
Source: Deborah Brewis, Review of Evidence of Inequalities in Access to Health Services in Wales and the UK: Gender, gender reassignment, and sexual identity, Social Research Paper 8/2014, Welsh Government
Date: 2014-Feb
An article examined how welfare spending affected inequalities in self-rated health across Europe, as well as the level of poor self-rated health in the low-education group across varying levels of social spending. Absolute and relative educational inequalities in poor health were found to be smaller in European countries with high social spending. The association was more marked among women than among men.
Source: Espen Dahl and Kjetil van der Wel, 'Educational inequalities in health in European welfare states: a social expenditure approach', Social Science & Medicine, Volume 81
Links: Abstract
Date: 2014-Feb
An article discussed the evaluation of Healthy Start, a targeted United Kingdom food subsidy programme that gave vouchers for fruit, vegetables, milk, and vitamins to low-income families. It said that vouchers had increased the quantity and range of fruit and vegetables used and improved the quality of family diets, and that this was reported to have established good habits for the future. The study had found barriers to scheme registration and use of the vouchers. The article outlined a range of issues that could compromise the success of such programmes.
Source: Alison McFadden, Josephine Green, Victoria Williams, Jenny McLeish, Felicia McCormick, Julia Fox-Rushby, and Mary Renfrew, 'Can food vouchers improve nutrition and reduce health inequalities in low-income mothers and young children: a multi-method evaluation of the experiences of beneficiaries and practitioners of the Healthy Start programme in England', BMC Public Health, Volume 14
Date: 2014-Feb
An article examined the vulnerability of mental health of young people aged 10–20 to neighbourhood factors that were theoretically associated with increased risk of common mental disorders. It said that material socio-economic deprivation and violence/victimization were associated with common mental disorders among young people, though the majority of studies were cross-sectional rather than longitudinal.
Source: Sarah Curtis, Rachel Pain, Sara Fuller, Yasmin Khatib, Catherine Rothon, Stephen Stansfeld, and Shari Daya, 'Neighbourhood risk factors for common mental disorders among young people aged 10-20 years: a structured review of quantitative research', Health and Place, Volume 20
Links: Abstract
Date: 2014-Feb
An article examined whether material deprivation was an important determinant of health inequalities in adolescents in the United Kingdom and Canada.
Source: James Fagg, Sarah Curtis, Steven Cummins, Stephen Stansfeld, and Amelie Quesnel-Vallee, 'Neighbourhood deprivation and adolescent self-esteem: exploration of the 'socio-economic equalisation in youth' hypothesis in Britain and Canada', Social Science & Medicine, Volume 91
Links: Abstract
Date: 2014-Feb
A report provided the findings from a policy commission on healthy ageing. It said that the experience of ageing was complex, bore little relationship to age, and was viewed in a variety of ways by people from the wide range of nationalities, ethnicities, languages, faiths, and cultures that resided in the United Kingdom. The report said that health inequalities associated with socio-economic disadvantage were also found in the older population, and that longer term planning was needed to provide services that respected older people's desire for control and independence alongside meeting their need for security, care, and support. The report made recommendations for commissioners and providers of health and social care, as well as for ongoing research.
Source: Birmingham Policy Commission, Healthy Ageing in the 21st Century: The best is yet to come, University of Birmingham
Links: Report | Summary | University of Birmingham press release
Date: 2014-Feb
An article said that that higher rates of schizophrenia in urban areas could be attributed to increased deprivation, increased population density, and an increase in inequality within a neighbourhood. A one percentage point increase in either neighbourhood inequality or deprivation was associated with an increase in the incidence of schizophrenia and other similar disorders of around four per cent.
Source: James Kirkbride, Peter Jones, Simone Ullrich, and Jeremy Coid, 'Social deprivation, inequality, and the neighborhood-level incidence of psychotic syndromes in east London', Schizophrenia Bulletin, Volume 40 Issue 1
Links: Abstract | Cambridge University press release | Wellcome Trust press release
Date: 2014-Feb
An article said that the gap in heart disease deaths for those aged over 65 in the richest and poorest areas of England had widened since the 1980s, despite general improvements.
Source: Perviz Asaria, Lea Fortunato, Daniela Fecht, Ioanna Tzoulaki, Juan Jose Abellan, Peter Hambly, Kees de Hoogh, Majid Ezzati, and Paul Elliott, 'Trends and inequalities in cardiovascular disease mortality across 7932 English electoral wards, 1982–2006: Bayesian spatial analysis', International Journal of Epidemiology, Volume 41 Number 6
Links: Abstract | BBC report
Date: 2014-Feb
An article examined the ENRICH programme, which aimed to develop the knowledge base for reducing differences in pathways to mental healthcare for black and minority-ethnic groups in England. It reported on three studies that aimed to: understand ethnic differences in pathways to care; evaluate the process of, and predictors for, detention under the Mental Health Act; and examine the suitability of generic early intervention services for different ethnic groups.
Source: Swaran Singh, Zoebia Islam, Luke Brown, Ruchika Gajwani, Rubina Jasani, Fatemeh Rabiee, and Helen Parsons, 'Ethnicity, detention and early intervention: reducing inequalities and improving outcomes for black and minority ethnic patients: the ENRICH programme, a mixed-methods study', Programme Grants for Applied Research, Volume 1 Number 3
Links: Scientific summary | Report
Date: 2014-Jan
A report compared three major health problems in a range of English cities (London, Birmingham, Bristol, Leeds, Liverpool, Manchester, Newcastle, Nottingham, and Sheffield) with the amount of available green and public space. It said that the areas of the cities with the poorest health outcomes had the least amount of green space. It outlined ideas for action by developers, councils and the government.
Source: Rebecca Roberts-Hughes, City Health Check: How design can save lives and money, Royal Institute of British Architects
Links: Report | RIBA press release
Date: 2014-Jan
