A new coalition of nearly 80 organisations, including the Royal College of Physicians of Edinburgh, has been launched to press for urgent action to address health inequalities.

The Inequalities in Health Alliance (IHA), which was brought together by the Royal College of Physicians of London, is calling for a cross-government strategy to reduce health inequalities: unfair and avoidable differences in health across the population, and between different groups within society. Health inequalities, which may involve differences in access to health care or  the standards of care available, can damage quality of life and even shorten life expectancy.

Research commissioned for the launch of the IHA shows widespread concern over health inequalities and overwhelming support for action.

Almost two thirds (65%) of those surveyed by Yonder felt that governments across the UK – including the Scottish Government - should be doing to more to address the issue and 81% agreed (52% strongly) that there should be a UK government strategy to reduce inequalities in health.

There are many causes of health inequalities but deprivation is a key factor. Of those surveyed, 78% agreed (50% strongly) that all parts of government in each part of the UK should have to consider the impact of their policies on people who are less well off. Three quarters (75%) were concerned – 35% very concerned - that the health gap between wealthy and deprived areas is growing (Health Equity in England: the Marmot review 10 years on, January 2020).

Nearly a quarter (24%) selected access to healthcare as the health inequality they were most concerned about, with 17% opting for poor mental health and 16% long term health conditions.

The IHA has written to the UK Prime Minister, Boris Johnson MP, noting that the UK Government has been focused on responding to the pandemic but pointing out that, with its impact felt differently by different communities, COVID-19 has exposed how health inequalities can have an impact not just over a lifetime, but a matter of weeks. Now, the second wave of COVID-19 is hitting those already most disadvantaged in our society.

As well as calling on the Prime Minister to develop a cross-government strategy to reduce health inequalities, the IHA wants the UK Government to use the socio-economic duty, section 1 of the Equality Act 2010, to address health inequalities and to adopt a ‘child health in all policies’ approach.

Professor Angela Thomas OBE, president of the Royal College of Physicians of Edinburgh said:

We are deeply concerned by the impact the pandemic is already having on the economy in Scotland and across the UK, which is in turn affecting some of the most economically vulnerable groups – such as those on low incomes and workers under the age of 25. We know that the UK has experienced a sharp increase in new claims for Universal Credit since the pandemic began for example, and we fear that a fall in household incomes could make existing debt more of a challenge for some families, particularly where debt repayments already absorb a significant share of household income.

With the potential for more household borrowing too, adding to existing debt built up during austerity, we are concerned that the pandemic could make the poorest households poorer. We know that the most deprived parts of the UK also have the poorest health, so we would encourage cross-government action as a matter of urgency.

Professor Andrew Goddard, president of the Royal College of Physicians of London said:

Health inequalities are not an issue to be addressed once the pandemic is behind us; a focus on them is one way in which we can tackle COVID-19 in the short term, and help to reduce its impact upon the health and prosperity of the UK in the longer term.

That such a large number and wide range of organisations should come together to form the Health Inequalities Alliance is a powerful statement that now is the perfect time to reduce the gap in healthy life expectancy by taking the right steps to reset the NHS, make social care sustainable, and reinvigorate our approach to public health.

Professor Sir Michael Marmot, Director of the UCL Institute of Health Equity and author of several key reviews looking at health inequalities, said:

The pandemic has exposed and amplified underlying inequalities in society. Health inequalities are the result. Tackling the social causes of health inequalities is even more urgent now. It is so important that these health care organisations have taken a leadership role in improving the health of the whole of society.