Creating a fairer Britain
Good health is not only an asset in itself; it also enables people to further their careers, look after families, and pursue their other interests to the full. Many Britons think that their health is ‘good’ or ‘very good’. Most of us are confident that when we need help the National Health Service will treat us with respect and dignity.
The evidence suggests, however, that there are some groups of people who are more likely than average to experience ‘poor’ health, and some who find it difficult to access care and support that meets their particular needs. While there are obvious differences in the health needs of men and women, the evidence does not suggest a clear trend of either gender experiencing worse health than the other. Both genders may find that their health needs are not met: men are less likely to use their GP; women have specific concerns about maternity services. Both genders have a mixed record when it comes to looking after health. Men are more likely to take exercise but less likely to eat the recommended amounts of fruit and vegetables, and women vice-versa.
Our health needs change as we age. The incidence of disability rises with age and older people (65 and over) also have a higher rate of depression than younger people. There is evidence to suggest that the health service sometimes deals with some older people in ways that they find humiliating or distressing.
Overall, around 1 in 5 of us report a disability or limiting long-term illness (LLTI). The available evidence suggests that people who report a disability or LLTI are as likely as average to say that the health services treats them with dignity and respect.
In terms of ethnicity, evidence indicates that Pakistani and Bangladeshi groups are more likely to report ‘poor’ health than average. These groups are more likely to experience poor mental health, more likely to report a disability or LLTI, and more likely to find it hard to access and communicate with their GPs than other groups. Among groups defined by religion, Muslim people tend to report worse health than average. It is unclear how far these worse-than-average outcomes are related to Pakistani, Bangladeshi and Muslim people’s relatively poor socio-economic position.
Research has suggested that there may be an association between harassment and poor mental health. Some evidence suggests that lesbian, gay and bisexual (LGB) and transgender people, Gypsies and Travellers and asylum seekers, who are perhaps more likely than other groups to face hostility and misunderstanding, are all more likely to experience poor mental health.
Sometimes, these same groups can feel misunderstood by the health services themselves. Some transgender people do not feel that their doctor supports their decision to seek gender reassignment, and some Gypsies and Travellers find it difficult to register with a GP.
Finally, there is a strong association between low socio-economic status and poorer health: in England and Wales, those who have never worked or are long-term unemployed have the highest rates of self-reported ‘poor’ health; people in routine occupations are more than twice as likely to say their health is ‘poor’ than people in higher managerial and professional occupations; and people from lower socio-economic groups are more likely to have a poor diet and less likely to take regular exercise.
Geography matters, as does socio-economic circumstance – incidence of ill health is closely associated with area deprivation, especially among those under 65.
The available evidence points to poorer health outcomes for many equality groups, partially but not completely explained by generally worse socioeconomic circumstances. This also includes higher mortality rates from specific medical conditions.
Some ethnic minority groups appear to have worse general self-reported health than the White British majority, particularly Bangladeshi and Pakistani people. These health disparities persist even taking socio-economic circumstances into account.
Groups vulnerable to pressures such as poverty and victimisation show high rates of mental illness. The risk of having poor mental health scores is higher for certain ethnic groups with high poverty rates.
The number of people of normal or healthy weight is declining and obesity is on the rise. Only around 30-40% of men and women in Britain are of a normal or healthy weight.