Health Inequalities
Health inequalities are avoidable, unfair, and systematic differences in health between different groups of people (Kings Fund, Aug 21).
Those living in the most deprived areas are more likely to experience health inequalities and have poorer health outcomes than those living in the least deprived areas. Across our Integrated Care System (ICS), those in the most deprived areas in Nottingham City are dying 7-8 years earlier than those in the least deprived areas in Rushcliffe. In addition to this, people in more deprived areas spend more years in poor health than those in the least deprived areas, those on the lowest incomes are 4x more likely to have multiple long-term conditions. In Nottingham City, healthy life expectancy is around 57 years old, this is lower than the England average of 62 years.
The causes of health inequalities are complex but are generally associated with variation in a range of factors that positively or negatively influence our ability to be healthy. These conditions influence our opportunities for good health, and how we think, feel and act, and this shapes our mental health, physical health, and wellbeing (UK Government, 2021). The quality of health care only accounts for around 10% of the contribution to health inequalities. Financial insecurity and poor-quality housing have the biggest impacts. However, we need to consider how these factors impact the people using our services and the medical conditions they are experiencing.
You can read more about Health Inequalities here:
NHS England » What are healthcare inequalities?
NICE and health inequalities | What we do | About | NICE
What are health inequalities? | The King's Fund (kingsfund.org.uk)
Multiple conditions and health inequalities: addressing the challenge with research (nihr.ac.uk)
Core20PLUS5
Core20PLUS5 is a national NHS England approach to inform action to reduce healthcare inequalities at both national and system level. The approach defines a target population – the ‘Core20PLUS’ – and identifies ‘5’ focus clinical areas requiring accelerated improvement whilst also recognising the impact of smoking. There are two approaches, one for adults and one for children and young people.
The Core20 refers to the 20% most deprived populations identified nationally. These are the populations who are most likely to experience the poorest health outcomes. In our ICS, Nottingham City, Mansfield, and Ashfield have the highest proportion of Core20 populations. 55% of Nottingham City, 42% of Mansfield and 29% of Ashfield GP registered populations are within Core20.
The Plus population might be people from ethnic minority communities; people with a learning disability, people with multiple long-term health conditions; other groups that share protected characteristics as defined by the Equality Act 2010 and inclusion health groups (people experiencing homelessness, drug and alcohol dependence, vulnerable migrants, Gypsy, Roma and Traveller communities, sex workers, people in contact with the justice system, victims of modern slavery and other socially excluded groups).
You can read more about Core20PLUS5 here:
NHS England » Core20PLUS5 (adults) – an approach to reducing healthcare inequalities
Population profile
Understanding our local population demographics is key when considering health inequalities. It will help us understand the needs of the population that we are serving.
You can find out about the population in your area using from the Office for Health Improvement and Disparities or the Nottingham/Nottinghamshire health and wellbeing website.
Office for Health Improvement and Disparities - GOV.UK
Health literacy
Health literacy is a person's ability to understand and use information to make decisions about their health.
A user with low health literacy will generally struggle to:
- read and understand health information.
- know how to act on this information.
- know which health services to use and when to use them.
Complex health materials can be a barrier to healthcare access and achieving optimal treatment of medical conditions. Low health literacy is associated with poorer health and higher mortality and is often lower in areas of high deprivation. It's estimated that health literacy-related problems account for up to 5% of national health spending.
The link below estimates the percentage of the population with low health literacy in Local Authority areas. In Nottingham City, it is estimated 53% of the population aged 16-64 are below the threshold for health literacy.
HEALTH LITERACY - Home (geodata.uk)
The NHS Health Literacy Toolkit can be used below:
Health-Literacy-Toolkit.pdf (library.nhs.uk)
.