NHS must act to reduce health inequalities

According to a report presented by the Institute of Health Equity at the London headquarters of the British Medical Association (BMA), action must be taken to reduce the health divide between the rich and poor.

The report, which has the support of the BMA, stresses that insufficient attention is paid to the social and economic conditions that contribute to poor health. It highlights the problem by pointing out that in England the life expectancy of the best off is seven years longer than that of the poorest; this gap rises to 17 years in London and 28 years in Glasgow.

ProfessorSir Michael Marmot, whose 2010 review “Fair society, healthy lives” highlighted health inequalities and who helped prepare the report, says that although Britain has the world’s most equitable health service, social inequalities are leading to inequalities in health. In his 2010 review he assessed that health inequality costs Britain some £31-33bn annually in lost production and taxes, £20-32bn in welfare payments and £5.5bn in additional costs to the NHS.

Professor Marmot believes that while health professionals are aware of the problem, there is a sense that others should deal with it and that there is little they can do. Many organisations and individuals, however, have received the report favourably and agree that action is both necessary and possible.

BMA representative Dr Vivienne Nathanson says that many doctors are already looking at the social conditions that contribute to their patients’ ill health, but there is a need to spread the word about this integrated approach to treatment.

For his part, Health Secretary Jeremy Hunt supports the report and has called on health professionals to deal not only with medical issues but also the underlying social and economic causes of ill health. The NHS, he points out, has a legal duty to reduce health inequality.

In April, responsibility for the prevention of ill health passed to local authorities. The report, however, is aimed at the health service. Among its key recommendations are:

•          Access to potential medical careers for people from all backgrounds should be improved.
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•          Health service providers should act as advocates for patients and for changes in policies.
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•          Social history should be recorded alongside medical history and medical practitioners should provide referrals to other relevant agencies for those in need
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•          Medical training and professional development should include the social determinants of ill health.