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Health inequalities in South Gloucestershire

South Gloucestershire is generally seen as a healthy place to live and work, with low levels of deprivation and good health and wellbeing outcomes for the local population. This is, however, not the full picture and data in the Joint Strategic Needs Assessment describe unmet need in some of our communities, and identifies groups of the population with much poorer health and emotional wellbeing than the majority within South Gloucestershire.

A robust and growing body of evidence suggests that tackling inequalities helps those with the poorest health, but also improves the health status of all communities, including the seemingly affluent.  Reducing inequalities is not only the right thing to do, but will have social and economic benefits for all. Reducing inequalities is therefore a key focus of all actions proposed in this strategy.

What are inequalities in health?

Health inequalities are the differences in health status or the distribution of health determinants between people or groups due to social, geographical, biological or other factors. These differences are preventable and unjust differences in health status have a huge impact because they result in some people experiencing poorer physical and mental health and wellbeing, increased disability and shorter lives.

National and local data tell us about groups who are more likely to experience health and social inequality. There are a range of factors that can increase or contribute to the risk of being vulnerable to inequality. They include, but are not limited to, who you are (inequalities are often aligned to the protected characteristic groups identified in the Equality Act 2010 i.e. age, gender, disability, religion and belief, race, sexual orientation, gender re-assignment, pregnancy and maternity and marriage and civil partnership) and where you live (geography can impact on opportunities to access services, good housing, education and employment, and to adopt healthy lifestyle choices).

Some inequalities are geographical. These are defined using the English Indices of Deprivation which identifies areas where higher numbers of people don’t achieve their full potential, have poorer health outcomes, are employed in less well paid jobs or are unemployed and there are higher levels of crime. The most deprived areas of South Gloucestershire are clustered within the urban wards of Staple Hill, Kings Chase, Patchway, Parkwall and Woodstock, though other areas exist.  A man living in one of the most deprived areas of South Gloucestershire has a life expectancy at birth 9.1 years shorter than a man living in one of the least deprived areas. Similarly a woman living one of the most deprived areas has a life expectancy 7.2 years shorter than a woman in one of the least deprived areas.

There are inequalities across South Gloucestershire. More than 6,000 children live in poverty in South Gloucestershire, two thirds of whom live outside the priority neighbourhoods. Child poverty is a major source of inequalities which can persist throughout life. A child growing up in poverty has a greater likelihood of experiencing health problems from birth and of accumulating physical and mental health problems throughout life. Children with free school meal status (an indicator of poverty) are more likely to be lower educational achievers. South Gloucestershire children receiving free school meals are likely to do less well compared to areas of the country with higher levels of child poverty and children on free school meals. Children who grow up in poverty are four times as likely to be poor adults, becoming the parents of the next generation of children living in poverty.

Other groups particularly vulnerable to inequalities in health outcomes in South Gloucestershire include:

  • Carers
  • Children, young people and adults with a physical or learning disability
  • Looked after children and care leavers
  • Children, young people and adults who have or are experiencing violence or abuse
  • Children, young people and adults living in poor housing or those who are homeless
  • Children, young people and adults with mental health problems
  • People in the criminal justice system
  • Some ethnic groups

Health inequalities result from social, economic and environmental inequalities. Action on health inequalities requires action across all the social determinants of health and an effective local delivery system with a focus on health equity in all policies and engagement from organisations across the health and care, the voluntary and private sector and community groups.

Local action within and beyond this strategy will be informed by the six objectives in the national Marmot Review: Fair Society Healthy Lives, which proposes an evidence-based strategy to address key factors leading to health inequalities. They are:

  1. Give every child the best start in life
  2. Enable all children, young people and adults to maximise their capabilities and have control over their lives
  3. Create fair employment and good work for all
  4. Ensure healthy standard of living for all
  5. Create and develop healthy and sustainable places and communities
  6. Strengthen the role and impact of ill-health prevention.