No change in health gap between England's richest and poorest

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Summary and full copies of the HSE 2009
UCL Epidemiology & Public Health
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Significant health inequalities still exist between the country's richest and poorest according to the latest findings from the biggest annual survey of health in England, The Health Survey for England.

The survey, conducted by UCL and the National Centre for Social Research and funded by The NHS Information Centre, shows that people in the lowest income households continue to experience much worse outcomes across key health measures than people in the highest income households.

Men and women in the lowest income bracket are three times more likely than those in the highest income bracket to have kidney disease and to smoke. The disparity in health between England's richest and poorest is particularly marked amongst women, with those in the lowest income bracket four times more likely to be diagnosed with diabetes and twice as likely to be obese than women in the highest income bracket.

Vasant Hirani, Senior Research Fellow in UCL's Department of Epidemiology and Public Health, and co-editor of the study, said: "This important survey provides an annual health check for the nation, and shows that there are still marked inequalities in health between different socio-economic groups. There is a clear social gradient, with people with lower incomes much more likely to experience poor health than those that are more affluent. We need to reduce inequalities and improve health outcomes for some of the most vulnerable groups in our society - a real challenge in the current economic climate."

Rachel Craig, Research Director at the National Centre for Social Research, and co-editor of the study added: "The Health Survey for England gives us an excellent picture of how health changes over time, allowing us to accurately monitor the problem areas of health inequality in Britain today. As the coalition takes a new approach to public health during a time of high satisfaction levels in the NHS it will be vital to monitor how outcomes develop. In particular, it will be interesting to see how successful the government plans are to 'nudge' people towards making healthy lifestyle choices."

Key measures of health covered by the latest report include:

Kidney disease

The Health Survey this year provides the first national picture of chronic kidney disease. Results show that between 5% and 10% of adults have symptoms of kidney damage, although only around 2% report a doctor's diagnosis of kidney disease.

Three times as many men in the lowest income bracket have kidney disease than men in the highest income bracket (2.4% compared with 0.8%) and nearly three times as many women in the lowest income bracket (1.4%) than women in the highest income bracket (0.5%).

Diabetes

Overall, 9% of men and 6% of women aged 35 and over reported doctor-diagnosed diabetes. The biggest disparity in prevalence is between women in the highest and lowest income brackets. Women in the lowest income bracket are much more likely to suffer from diabetes (8%) in comparison with women in the highest income bracket (2%). Amongst men the prevalence rate is lowest for those in the highest income bracket (7%) and highest for men in the middle income bracket (11%).

Adult obesity

Obesity has been on the rise for 20 years but we are beginning to see the trend is slowing down. However nearly 2 in 3 men and women in Britain are overweight, with 22% of men obese and 44% overweight . 24% of women are obese and 33% overweight.

Women in the lowest income bracket are twice as likely to be obese, with a 33% prevalence rate for this group in comparison with 17% of women in the highest income bracket. This is important because being overweight increases a person's risk of developing health problems such as heart attack, stroke, type 2 diabetes, high blood pressure and some types of cancer.

Smoking

For both men and women, smoking prevalence was around three times higher among those from the lowest income households (40% for men and 34% for women) than among those living in the highest income households (14% for men and 11% for women).

Alcohol consumption

In contrast to other health measures, alcohol consumption is one area where lifestyles are less healthy among the better off. Men and women in the highest income bracket were most likely to have drunk alcohol in the last week (86% and 72% respectively); the proportion that had drunk in the last week declined in line with income, so that just 54% of men and 47% of women in the lowest income bracket had drunk alcohol in the last week. Men and women in the highest two income brackets were also more likely than others to have drunk alcohol on five or more days in the week.

Fruit and vegetable consumption

Adults in the higher income brackets were more likely than those in the lower income brackets to eat the recommended five or more portions per day: 32% of men and 37% of women in the highest bracket did so, compared with 18% and 19% respectively in the lowest bracket.

Longstanding illness

Both men and women in the highest income bracket were less likely to report a longstanding illness than those in the lowest income bracket (38% of men and 37% of women in the highest income group compared with 49% of men and 52% of women in the lowest income group). Examples of longstanding illness include asthma, diabetes, arthritis and stroke.

Self-reported general health and acute sickness

Both men and women in the lowest income bracket were most likely to consider their health as bad or very bad (18% of men and 15% of women compared with 3% of men and 2% of women in the highest income bracket). Men and women in the lowest income bracket were most likely to have cut down on the things they usually did in the last two weeks because of illness or injury (17% of men and 23% of women compared, with 10% of men and 12% of women in the highest income bracket).

Media contact: Ruth Howells

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UCL Context

UCL Epidemiology & Public Health is a multi-disciplinary department that aims to develop a better understanding of health and prevention of ill health through vigorous research and the development of research methodology. This knowledge is applied via undergraduate and graduate teaching, contributions to national and international health policy and contributions to the wider public understanding on health.

A unique and comprehensive source of health information, the Health Survey for England draws on data from interviews and measurements of thousands of adults and children. It is designed to inform national health policy and stimulate research by providing accurate and detailed data about the health needs of the general population.

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