Health Inequalities

By Dr Ananya Mandal, MD

Health inequality refers to the differences in healthcare provision between two or more demographic groups despite them having comparative access to healthcare services.

Examples of these differences include higher death rates among those from lower occupational classes compared with those from higher classes and a greater likelihood of people from ethnic minorities being diagnosed with a mental health condition.

In Canada, the public’s attention was drawn to this issue by the LaLonde report, which was described as the “first modern government document in the Western world to acknowledge that our emphasis upon a biomedical health care system is wrong, and that we need to look beyond the traditional health care (sick care) system if we wish to improve the health of the public.”

In the United Kingdom the first such report was the Black Report in 1980, which outlined how widespread health inequalities still existed despite improvement in the general population’s health since the introduction of the welfare state.

In 2010, Sir Michael Marmot from University College London, published the “Fair Society, Healthy Lives” report, which examined the relationship between poverty and health. He described a “social gradient in health” and reported that life expectancy was around seven years shorter among the poorest individuals compared with the most wealthy individuals. He also found that the poor were more likely to have a disability. Other researchers responded that these disparities were due to an increased uptake of unhealthy lifestyle factors such as smoking and poor diet among the poor in Britain.

Some factors that have been identified as leading to health inequalities include differences in education, food availability, living and working conditions, occupation, work environment, unemployment, housing, water and sanitation, access to healthcare, community factors, lifestyle factors, age, sex, disability and general health.

Reviewed by , BSc

Further Reading

Last Updated: Aug 6, 2014

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