The Health Gap.
What is the Health Gap?
Differences in health can be seen across NHS Greater Glasgow and Clyde and there is a widening gap in health between the richest and poorest. Men in the least deprived areas can expect to live 13-14 years more than those in the most deprived areas of the city. The gap for women is 8-9 years
Social class underpins these differences and is a major cause of health inequality Discrimination as a result of gender, race, disability, age and sexual orientation, combined with a person’s social class can have a combined negative effect on health. People also experience a decrease in health as their social position decreases. This is called the health gradient.
What can the NHS do to tackle the Health Gap?
NHS Greater Glasgow and Clyde has a significant role to play in reducing health inequalities by the way that it provides its services and allocates its resources. Historically, the approach to tackling inequalities has been to target communities who experience the worst health and support individuals to find ways to become healthier. These communities need support but this has not affected the size of the health gap because more affluent communities have been improving their health as quickly, or more quickly than poorer communities.
Those in greatest need often have access to the least health care (often referred to as the ‘Inverse Care Law’ developed by Julian Tudor Hart). Indeed in Glasgow we have an even distribution of GP practices - which does not reflect the distribution of poor health. Also, the way health care is organised favours people who:
| |
Have knowledge of the health care system and the confidence and assertiveness to use it
|
| |
Can communicate and can be communicated with at several levels- i.e. have spoken English as their first language, who can read and who have no sensory impairments such as blindness.
|
| |
Can travel easily to hospitals, health centres etc or for whom there are no physical barriers (such as difficulties walking)
|
| |
Have health problems which are largely unrelated to their life circumstances or discrimination |
The work that NHSGGC is involved in to develop an Inequalities Sensitive Health Service is designed to address these issues and also to find ways of sharing resources in a fairer manner. It also works with its partners to make an impact on the underlying causes of differences in health. This includes education, employment, housing, transport and other public services.
Useful Links
World Health Organisation Commission on Social Determinants of Health
Scottish Public Health Observatory- Health Inequalities
The Spirit Level: Why Equality is Better for Everyone
|
