Health inequalities in England: Major illness rate significantly higher in deprived areas

The Health Foundation report predicts that 80% of the increase in major illness among working-age people will be concentrated in more deprived areas

Health inequalities will persist over the next two decades, with long-term conditions like chronic pain, type 2 diabetes and anxiety and depression likely to increase at a faster rate in the most deprived areas, according to a new report from the Health Foundation.

People in the most deprived areas are anticipated to experience major illnesses 10 years earlier than those in the least deprived areas. They also face a threefold higher risk of dying before the age of 70 years.

Overall, the report projected that the number of working-age adults experiencing a major illness could grow from 3 million in 2019 to 3.7 million in 2040. Notably, 80 per cent of this projected increase is expected to be concentrated in more deprived areas (deciles 1–5).

In 2040, the number of working-age adults living with major illness in the most deprived areas is expected to be more than double the rate in the least deprived areas, with figures projected at 15.2 per cent compared to 6.8 per cent.  This contrasts with 14.6 per cent and 6.3 per cent respectively in 2019.

Led by the Health Foundation's Real Centre in collaboration with the University of Liverpool, the study examined inequalities in major illness among working-age people.

Govt should invest in primary care 

A small group of long-term conditions, including COPD, chronic pain, type 2 diabetes and anxiety and depression, are believed to be contributing most of the observed health inequalities.

Given that these conditions are typically managed by GPs and community services, the report emphasised the importance of investing in primary care and focusing on prevention.

In its previous report, the charity projected that 9.3 million people, around 1 in 5 adults in England, could be living with a major illness by 2040.

The majority of this rise is expected to occur among people aged 70 years and older. The number of this demographic group living with diagnosed a major illness is projected to increase to 5.5 million by 2040 from 3.6 million in 2019.

The report recommended that government action should include “policies at a population level, particularly to address the biggest risk factors that shape health outcomes – smoking, alcohol use, poor diet and physical inactivity – including bolder use of tax and regulation, and a focus on addressing the commercial determinants of health.”

Adding to the growing evidence, the Health Foundation report noted that “tackling health inequality cannot wait until we have economic prosperity; it is one of the key areas of national and local policy focus on which prosperity depends.”

Trusts need more support to tackle health inequalities

In response to this report, NHS Providers has emphasised the need for increased support and funding to assist trusts in addressing health inequalities.

Saffron Cordery, deputy chief executive at NHS Providers said: "More support and funding for public health services is vital to ensure a healthier population. Prevention is better than cure.

"These findings are worrying but sadly not surprising given the cuts to public health and prevention services over the years.

"National support is vitally needed for local councils to meaningfully improve the health and wellbeing of their communities. Without it, demand for already-stretched NHS services will rise even further.”

Furthermore, Cordery underscored the importance of adopting a whole-government approach to prevent ill health, starting with “tackling the root causes of why some people – such as those living in poverty and in deprived areas, as well as ethnic minorities and people with learning disabilities – are more likely to have worse physical and mental health.”

"Trusts are working hard to prevent ill health and reduce health inequalities. Alongside more support for community services and social care, there must be a greater focus on the wider factors that could help people to lead healthier and more productive lives,” she added.