Health inequalities

Inequalities are preventable, unfair and unjust differences in health status between groups, populations or individuals that arise from the unequal distribution of social, environmental and economic conditions within societies. These unequal conditions determine the risk of people getting ill, their ability to prevent sickness, and/or their opportunities to take action and access treatment when ill health occurs.^[1]

Inequalities in health outcomes are present in Norfolk & Waveney. Inequality in healthy life expectancy is 11 years for men and 9 years for women – meaning that men in the least deprived areas can expect, on average, to live 11 more years in good health than those in the most deprived areas.^[2] These differences in outcomes can be due to multiple factors, including inequalities in healthy lifestyle behaviours, living conditions, access to, and quality of, health services and the likelihood of living in poor health with long-term conditions.^[1]

Core20PLUS5 is a national NHS England and NHS Improvement approach to support the reduction of health inequalities at the national and system levels. The approach defines a target population cohort – the ‘Core20PLUS’ – and identifies ‘5’ clinical areas of focus requiring accelerated improvement.

The ‘Core20’ is the most deprived 20% of the national population as identified by the national Index of Multiple Deprivation (IMD). The IMD has seven domains with indicators accounting for a wide range of social determinants of health. The ‘PLUS’ element involves identifying specific population groups at the local level that warrant specific attention due to the health inequalities that they face such as those from ethnic minorities or those with learning disabilities.^[3]

There are 42 neighbourhoods (LSOAs) across Norfolk and Waveney where the population live in the 20% most deprived areas in England. However, none of these communities are in Broadland or South Norfolk. In 2022, around 40% of the populations of Great Yarmouth and Norwich live in the most deprived 20% of areas in England compared to 15% for Norfolk as a whole.^[4]

The Health Foundation explains that ‘Good Health is vital for prosperity, allowing people to play an active role at work and in their communities.’^[5] Improvements in life expectancy stalled in the decade before the pandemic^[6] and there are wide inequalities in health within, and between, local areas in the UK.

It is widely acknowledged that there are health inequalities in the UK which no single organisation or community can tackle alone. Several factors influence how long someone lives, such as where they live, whether they have faced discrimination and their employment prospects.

The health inequalities toolkit is a resource to help place-based organisations tackle health inequalities. It provides a step-by-step guide for organisations and communities which takes them to clear and considered action. The resources aid in clarifying the identified issue, its causes, what is happening right now in a specific place, and how communities can work together to address existing poor health outcomes.

It can be used as a whole or in part, and contains validated national tools as well as links to further information. All stages in the toolkit are accessible as the links below.