Latest news with #healthinequality
Yahoo
10-07-2025
- Health
- Yahoo
Study exposes ‘alarming' inequalities among child deaths in intensive care
Children from deprived areas of the UK are more likely to die in intensive care than youngsters in wealthy areas, a study suggests. There are also higher death rates among children of Asian ethnicity on these wards compared to white children, researchers said. Experts called for urgent action from policymakers and health leaders in light of the findings, which they described as 'deeply troubling'. For the study, researchers from Imperial College London, University of Leicester, UCL and University of Leeds analysed 245,099 admissions for 163,163 children to UK paediatric intensive care units (PICUs) between January 2008 and December 2021. Researchers found death rates were 4.2 per cent among the most deprived children at 2,432 deaths per 58,110 admissions, compared to 3.1 per cent among wealthy children with 1,025 deaths per 33,331 admissions. According to the study, youngsters living in the poorest areas had 13 per cent higher odds of dying compared to those living in the least deprived areas. Researchers also found 5.1 per cent of Asian children admitted to PICU died – 1,336 deaths per 26,022 admissions – compared to 3.2 per cent of white children, with 4,960 deaths per 154,041 admissions. Dr Hannah Mitchell, of the department of surgery and cancer at Imperial College London, said: 'Paediatric intensive care offers the highest level of support for the sickest children. 'Our findings show that inequalities persist even at this stage of care and are deeply troubling. 'These are not just statistics – they represent real, preventable differences in outcomes for critically ill children.' Elsewhere, the study found both deprived children and those of Asian ethnicity were more likely to be severely unwell when admitted to PICU compared to wealthier and white children. Youngsters from ethnic minority backgrounds also had longer stays in PICU – 66 hours on average – while white children averaged 52 hours. Dr Mitchell added: 'Our findings are especially alarming in the context of rising levels of child poverty in the UK, where 4.5 million children are now growing up in poverty (31 per cent of all children), 800,000 more children compared to 2013 (27 per cent of all children). 'These findings should prompt urgent action from policymakers and healthcare leaders.' Dr Mitchell said the study, published in The Lancet Child and Adolescent Health, 'adds clear, national-scale evidence of disparities in intensive care. 'Reducing avoidable deaths in children must include serious, sustained action to reduce child poverty, improve access to healthcare, and address the structural barriers faced by marginalised communities,' she added. Reacting to the study, Professor Habib Naqvi, chief executive of the NHS Race and Health Observatory, said: 'These sobering findings are shocking and unacceptable. 'Your ethnicity, background or where you live should not determine your chances of survival. 'We need immediate and collective action to address the issues outlined in this study, and in many other studies that show the impact structural inequalities and bias have on healthcare access, experience, and outcomes. 'Not tackling these issues is leading to avoidable harm to countless patients, families, and communities.'
The Guardian
04-07-2025
- Health
- The Guardian
Vital steps to move the NHS from cure to prevention
Your articles on health inequality this week included excellent coverage of the government's project to shift the emphasis of healthcare from treatment at the clinic and hospital to prevention through public health initiatives (Downing Street's radical plan for the NHS: shifting it from treatment to prevention, 29 June). However, one key element is missing from the analysis that has frustrated the implementation of such necessary innovations: the way that undergraduate students are educated and socialised into medicine within longstanding conservative curricula. Historically, doctors gain an identity that is grounded in the sanctity of the 'clinic' (primarily the hospital) as a well-patrolled territory with idiosyncratic rituals and language. Patients are kept on the other side of the fence. Medical education traditionally affords little work-based experience in the first two years, but after that students gain increasing exposure to clinical work. However, this is largely focused on secondary care (hospital and clinic) settings, and on cure rather than prevention. Medical students soon learn that their professional identity construction depends on strict separation from community-based practices such as social work as they identify with the curative rituals of the clinic. Healthcare as a whole will not be able to focus on prevention, as Wes Streeting wishes, until medical students' miseducation into the sanctity of clinical cure is addressed. This is a pedagogical challenge that must no longer pass under the Alan BleakleyEmeritus professor, Peninsula school of medicine, University of Plymouth Of course Denis Campbell is right to say that moving the NHS from treatment to prevention is a great idea. The problem is, and has been for years, that finding the money for preventing ill health is apparently impossible while the NHS still has to treat ill health that wasn't prevented. Treasury rules seem to forbid investing for future BaronFormer NHS trust chair Your report (29 June) on 'medieval' levels of healthcare inequality affecting the poorest sections of society is borne out by the National Diabetes Foot Care Report 2022 for England. This found that people with diabetes living in the most deprived areas of England are 82% more likely to undergo a major amputation than those in the least deprived. Such a predisposition to major amputation in the circumstances of poverty contributes to a postcode lottery with a 4.8-fold variation in major amputation rates, ranging from 3.5 to 16.8 amputations per 10,000 population with diabetes per year. People in deprived areas face economic and social barriers to care and restricted referral pathways, resulting in delayed access to specialist care. They are then too late for conventional treatment and require amputation, with all the suffering, costs and life-changing effects these have. Thus the income and home address of people living with diabetes can contribute significantly to whether they lose or keep their legs. However, it should be possible to prevent most major amputations. Such an aspiration is in keeping with the preventive ethos of the 10-year NHS plan, which it is hoped will facilitate more rapid and equitable access to initial care in the community and prevent amputations in all people living with Michael Edmonds, Jonathan Hunt (patient), Dr Erika Vainieri and Dr Chris ManuKing's College Hospital, London The excellent Black report on inequalities in health was commissioned by Labour in 1977 and published in 1980, by which time the Tories were in government and the report was marginalised and ultimately dismissed by them. The report recommended improvements in child benefits, childcare allowances, preschool education, school milk and meals, disablement allowances, housing and working conditions. Nothing new there, then. We know what needs to be done to make the quality of life more equal for all of us. Anyone who lives in or is familiar with those parts of the north (and elsewhere) suffering extreme deprivation knows that things must change. The situation is intolerable. It is a blight on our so-called civilised CooperLondon The ministerial U-turn on planned health-related benefit reforms included a welcome pledge to 'listen'. They would do well to study the link between deprivation and the 'lifestyle diseases' arising from obesity, smoking and excessive alcohol consumption. As well as explaining the 11-year life expectancy gap between the most and least deprived parts of the country, it is a vital but often overlooked factor in the debate over health and disability benefits. My research reveals that people in the poorest communities typically experience poor health up to 21 years earlier than those in richer areas. In Blackpool, for instance, 'healthy life expectancy' is just 53.5 years, compared to 74.7 years in Rutland. People in Blackpool are therefore far more likely to leave the workforce before state pension age – and therefore claim health and disability benefits – than those in Rutland. The government must pursue a longer-term approach to curb the rising welfare costs of poor health and disability. We need a comprehensive public health strategy to tackle the root causes of premature poor health. For too long successive governments have shied away from bold actions around smoking, obesity and alcohol to significantly improve public Les MayhewCity St George's, University of London Have an opinion on anything you've read in the Guardian today? Please email us your letter and it will be considered for publication in our letters section.
The Guardian
30-06-2025
- Health
- The Guardian
Health inequality is linked to gross disparities in wealth
Your article on health inequality (Britain's 'medieval' health inequality is devastating NHS, experts say, 29 June) describes the laudable efforts of NHS agencies to tackle some of the acute health problems in poorer areas. However, the real problem is that the reason we have such disparities in health is that they are directly related to the gross disparities in wealth and income in this country. As Prof Michael Marmot and many others have demonstrated, some of the most important factors in determining health are social and economic. It is all very well for the NHS to make efforts to actively address the effects of social and economic deprivation in poor areas, but this is managing symptoms rather than the cause. It is no coincidence that the UK has some of the worst health outcomes of developed countries and also among the worst levels of inequality. As the greatest advances in health in the past were not attributable to improvements in healthcare, but to improvements in the conditions in which people lived, so now it is reducing levels of poverty and inequality by economic and social change that are required to meaningfully address the problems identified in the article. While politicians pretend to want to address the problem, there is a consensus of inaction on the radical changes necessary because the consensus of our politics has drifted so far to the SmithGlasgow Re Britain's 'medieval' health inequality in what has been termed 'broken Britain', surely the only way in which the 'break' can be mended is tax increases. Why does this obvious solution not get the traction it requires? Those on reasonable incomes could pay more. Those with a lot of wealth should pay more. If there was ever a need it is now. Labour should bite the bullet, and MiskinSheffield Have an opinion on anything you've read in the Guardian today? Please email us your letter and it will be considered for publication in our letters section.
The Guardian
30-06-2025
- Health
- The Guardian
Britain's ‘medieval' health inequality is devastating NHS, experts say
Britain's 'medieval' levels of health inequality are having a 'devastating' effect on the NHS, experts have warned, with the health service estimated to be spending as much as £50bn a year on the effects of deprivation. Rising rates of child poverty have led to a growing burden on hospitals, with the knock-on cost to the NHS comparable to the annual defence budget. One senior NHS figure said they were seeing 'medieval' levels of untreated illness in some of Britain's poorest communities, including people attending A&E 'with cancerous lumps bursting through their skin'. Another said hospitals were witnessing a 'chilling' trend of vulnerable people, young and old, deliberately self-harming to secure an overnight stay. Concern has also been raised about rising rates of 'Dickensian' illnesses, including scabies, rickets and scarlet fever. The disclosures are revealed as part of a months-long Guardian investigation into the effects of deepening poverty on a 'broken' NHS. Rachel Reeves, the chancellor, earlier this month unveiled a £29bn real-terms increase in day-to-day NHS spending – up to £226bn by 2029 – rising to almost half of all non-capital public spending by the government in that time. Wes Streeting, the health secretary, has pledged to direct billions of pounds of extra NHS funding into poor areas by banning hospitals from overspending and overhauling the formula used to decide the levels of funding GP surgeries receive. This Thursday he will unveil the government's 10 year health plan, which will include radical plans to transform the NHS from a service primarily focused on treating illness to preventing it. However, NHS trust leaders are warning that cuts to other key areas – and long-delayed plans to reform social care and tackle child poverty – will leave hospitals and GPs having to 'deal with the fallout'. There is also unease about how Streeting's ambition to shift the health service from treatment to prevention square with the deep cuts to regional integrated care boards, which are under pressure to axe as many as 12,500 jobs by the end of this year. Saffron Cordery, the deputy chief executive of NHS Providers, which represents NHS trusts, called for a cross-governmental approach to tackle the impact of poverty on health. 'Prevention is better than cure but after many years of underinvestment and cuts there is a lot more to do to achieve the government's ambition of a clearer focus on preventing ill health,' she said. 'Made worse by the cost of living crisis, poverty has played a part in driving record demand for stretched mental health services, particularly among children and young people.' A comprehensive report published by the Joseph Rowntree Foundation (JRF) in 2016 estimated that £29bn of NHS spending was associated with poverty. One of the report's authors, Prof Donald Hirsch of Loughborough University said that although the exact cost today cannot be known without repeating the study, it was likely to be much higher. 'We spend a lot more on the NHS now than in 2014, and if the fraction attributable to poverty were the same, the cost would have risen to nearly £50bn,' he said. 'In fact it could be much higher, since far more people are experiencing severe hardship, including hunger and destitution, which could have strengthened the links between poverty and ill health, and hence higher health spending.' Studies suggest about a quarter of all spending in acute hospital care and primary care can be attributed to greater use of these services by people in poverty. At £50bn a year, spending on health deprivation would be similar to the defence budget and account for about £1 in every £10 spent by the government on all public services. A report by the Royal College of Physicians, published last week, estimated that air pollution – which disproportionately affects deprived communities – was contributing to about 30,000 deaths a year and about £500m a week in NHS and economic costs. Katie Schmuecker, the principal policy adviser at the JRF, said: 'Without an urgent commitment to tackling deep poverty, no plan to improve public services can succeed and the NHS and economy will continue to suffer as a result. 'Hardship is causing avoidable harm to people's health as well as holding back our economy, and failing to act on this costs us all dear.' Schmuecker said widespread deprivation was having a 'devastating' effect on the NHS and the economy. Studies have shown that those living in poverty are getting sicker and access healthcare later, contributing to A&E admissions that are nearly twice as high in the poorest groups and emergency admissions that are 68% higher. Dr Andy Knox, the acting medical director of Lancashire and South Cumbria integrated care board, which spans some of the poorest areas of Britain, said only 'full systemic change' in the approach to public health would curb widening inequality. 'There is an urgency to the situation we find ourselves in,' he said. 'We have not created a healthy society, and particularly for our most disadvantaged communities, this is now having a profoundly negative effect and placing huge pressure on our health and care system.' A report by the Health Foundation last year found that health inequalities are expected to continue over the next 20 years, with people in the poorest areas likely to be diagnosed with major illness a decade earlier than people in the wealthiest. The life expectancy gap between these areas has widened across Britain since 2013, according to the Office for National Statistics. Hugh Alderwick, of the Health Foundation, said the government's mission to tackle poverty and its impact on health 'appears to be missing in action'. He said pressure on the NHS would continue to grow without 'meaningful policy action to improve people's social and economic conditions'. A government spokesperson said ministers were 'determined to change people's lives for the better, helping them out of poverty and protecting those who need it most'. The spokesperson added: 'As part of our plan for change we announced a new £1bn package to reform crisis support, as well as the expansion to free breakfast clubs, increasing the national minimum wage and supporting 700,000 of the poorest families by introducing a fair repayment rate on universal credit deductions. 'We are also reforming the NHS so it is there for everyone, regardless of who they are or where they live, and have hit the ground running, delivering an extra 3.6m appointments since July to cut waiting lists.'
The Guardian
29-06-2025
- Health
- The Guardian
Britain's ‘medieval' health inequality is devastating NHS, experts say
Britain's 'medieval' levels of health inequality are having a 'devastating' effect on the NHS, experts have warned, with the health service estimated to be spending as much as £50bn a year on the effects of deprivation. Rising rates of child poverty have led to a growing burden on hospitals, with the knock-on cost to the NHS comparable to the annual defence budget. One senior NHS figure said they were seeing 'medieval' levels of untreated illness in some of Britain's poorest communities, including people attending A&E 'with cancerous lumps bursting through their skin'. Another said hospitals were witnessing a 'chilling' trend of vulnerable people, young and old, deliberately self-harming to secure an overnight stay. Concern has also been raised about rising rates of 'Dickensian' illnesses, including scabies, rickets and scarlet fever. The disclosures are revealed as part of a months-long Guardian investigation into the effects of deepening poverty on a 'broken' NHS. Rachel Reeves, the chancellor, last week unveiled a £29bn real-terms increase in day-to-day NHS spending – up to £226bn by 2029 – rising to almost half of all non-capital public spending by the government in that time. Wes Streeting, the health secretary, last week pledged to direct billions of pounds of extra NHS funding into poor areas by banning hospitals from overspending and overhauling the formula used to decide the levels of funding GP surgeries receive. This Thursday he will unveil the government's 10 year health plan, which will include radical plans to transform the NHS from a service primarily focused on treating illness to preventing it. However, NHS trust leaders are warning that cuts to other key areas – and long-delayed plans to reform social care and tackle child poverty – will leave hospitals and GPs having to 'deal with the fallout'. There is also unease about how Wes Streeting's ambition to shift the health service from treatment to prevention, to be unveiled next month as part of the plan, square with the deep cuts to regional independent care boards, which are under pressure to axe as many as 12,500 jobs by the end of this year. Saffron Cordery, the deputy chief executive of NHS Providers, which represents NHS trusts, called for a cross-governmental approach to tackle the impact of poverty on health. 'Prevention is better than cure but after many years of underinvestment and cuts there is a lot more to do to achieve the government's ambition of a clearer focus on preventing ill health,' she said. 'Made worse by the cost of living crisis, poverty has played a part in driving record demand for stretched mental health services, particularly among children and young people.' A comprehensive report published by the Joseph Rowntree Foundation (JRF) in 2016 estimated that £29bn of NHS spending was associated with poverty. One of the report's authors, Prof Donald Hirsch of Loughborough University said that although the exact cost today cannot be known without repeating the study, it was likely to be much higher. 'We spend a lot more on the NHS now than in 2014, and if the fraction attributable to poverty were the same, the cost would have risen to nearly £50bn,' he said. 'In fact it could be much higher, since far more people are experiencing severe hardship, including hunger and destitution, which could have strengthened the links between poverty and ill health, and hence higher health spending.' Studies suggest about a quarter of all spending in acute hospital care and primary care can be attributed to greater use of these services by people in poverty. At £50bn a year, spending on health deprivation would be similar to the defence budget and account for about £1 in every £10 spent by the government on all public services. A report by the Royal College of Physicians, published last week, estimated that air pollution – which disproportionately affects deprived communities – was contributing to about 30,000 deaths a year and about £500m a week in NHS and economic costs. Katie Schmuecker, the principal policy adviser at the JRF, said: 'Without an urgent commitment to tackling deep poverty, no plan to improve public services can succeed and the NHS and economy will continue to suffer as a result. 'Hardship is causing avoidable harm to people's health as well as holding back our economy, and failing to act on this costs us all dear.' Schmuecker said widespread deprivation was having a 'devastating' effect on the NHS and the economy. Studies have shown that those living in poverty are getting sicker and access healthcare later, contributing to A&E admissions that are nearly twice as high in the poorest groups and emergency admissions that are 68% higher. Dr Andy Knox, the acting medical director of Lancashire and South Cumbria integrated care board, which spans some of the poorest areas of Britain, said only 'full systemic change' in the approach to public health would curb widening inequality. 'There is an urgency to the situation we find ourselves in,' he said. 'We have not created a healthy society, and particularly for our most disadvantaged communities, this is now having a profoundly negative effect and placing huge pressure on our health and care system.' A report by the Health Foundation last year found that health inequalities are expected to continue over the next 20 years, with people in the poorest areas likely to be diagnosed with major illness a decade earlier than people in the wealthiest. The life expectancy gap between these areas has widened across Britain since 2013, according to the Office for National Statistics. Hugh Alderwick, of the Health Foundation, said the government's mission to tackle poverty and its impact on health 'appears to be missing in action'. He said pressure on the NHS would continue to grow without 'meaningful policy action to improve people's social and economic conditions'. A government spokesperson said ministers were 'determined to change people's lives for the better, helping them out of poverty and protecting those who need it most'. The spokesperson added: 'As part of our plan for change we announced a new £1bn package to reform crisis support, as well as the expansion to free breakfast clubs, increasing the national minimum wage and supporting 700,000 of the poorest families by introducing a fair repayment rate on universal credit deductions. 'We are also reforming the NHS so it is there for everyone, regardless of who they are or where they live, and have hit the ground running, delivering an extra 3.6m appointments since July to cut waiting lists.'
