Health inequalities

Health inequalities are differences in health between different population groups. The term can also refer to differences in access to healthcare, or the opportunities people have to lead healthy lives (for example, access to healthy food and living conditions). This includes differences within a country as well as differences between countries.

Health inequalities within a country usually result in those from lower socioeconomic backgrounds, or from minority and marginalised groups, having poorer health. For example, men in the richest parts of England live around 9 years longer than those in the poorest areas. No country is unaffected by health inequalities, and concerted efforts are needed to understand and reduce them across the globe.   

In our 10-year strategy, the Academy has committed to tackling health inequalities by influencing policy and practice, and ensuring that the UK’s research community is diverse, collaborative and inclusive. We are also working to broaden the range of people and disciplines engaged in biomedical and health research, including through the Academy’s grant schemes and programmes. Ensuring a diverse and inclusive health research ecosystem will help prevent different communities being excluded from medical research, which would create or worsen health inequalities. Learn more about the Academy’s work on health inequalities in the next tabs.

For more information about our work on global health inequalities, please see our dedicated project page.

The Academy submitted a response to the All-Party Parliamentary Group on Medical Research’s inquiry into the role of medical research in reducing health disparities. The Academy highlighted the need for data standardisation & access, interdisciplinary research, and translation & implementation of evidence to policy.

We have called for the use of both sexes in experimental design in a letter to the Medical Research Council, to ensure the applicability of preclinical research to both sexes, and emphasised the need for clinical trials to be representative of all groups in submissions to a MHRA consultation and a Government consultation on mental health and wellbeing. Similarly, we have advocated for diverse and inclusive workforces in submissions to Government consultations on diversity in STEM and the Women’s Health Strategy. 

Following the COVID-19 pandemic, we stressed the need for the research community to engage with and involve communities in our report COVID-19: Preparing for the future, to avoid them being left behind in responses to health challenges and emergencies.

The Academy’s major 2016 report ‘Improving the health of the public by 2040’ identified health inequalities as a cross-cutting theme when considering strategies to improve the nation’s health, requiring prioritisation by government and the research community to understand and address them. The report also recommended the establishment of the Strategic Coordination of Heath of the Public Research committee (SCHOPR). In the Health of the Public Research Principles and Goals set out by SCHOPR, the first overarching principle is to ‘undertake research to identify the most cost-effective methods to prevent ill-health, increase healthy life expectancies and reduce health inequalities.’

In 2022, the Academy co-organised a series of workshops with the InterAcademy Partnership on the theme of global health inequalities, exploring the impact of the COVID-19 pandemic. The report highlighted the need to:

• properly engage communities in research
• better collect and use data on health inequalities
• identify the interventions that work best
• anticipate the next pandemic or health emergency, and
• work in an interdisciplinary way to advance health inequality research.

The Academy co-hosted a joint virtual roundtable in November 2021 with the British Academy on geographic and historic patterns of health inequalities in the UK, in response to the effects of the COVID-19 pandemic on different communities. The report highlighted the value of historical perspectives and the need for coproduction of research when addressing health inequalities.

In 2020, the Academy’s FORUM hosted a workshop on public involvement and engagement in research during the COVID-19 pandemic, where participants emphasised the importance of engaging underrepresented groups in meaningful and long-lasting ways to reduce inequalities.

We recognise that involving patients and the public from diverse communities in our own activities is essential to ensure that everyone can benefit from the outcomes of our work.

We are increasingly looking to involve patients and the public in all areas of our work. Some examples of our public involvement and engagement are:

• Planet DIVOC-91 (2020), was a series of digital comics generated by young people from the UK, India and South Africa, to understand their views and changes in their mental health in response to the COVID-19 pandemic. They were encouraged to develop their own questions about the pandemic to interview experts, explore cross-sector problems and solutions, and write their own narratives around key themes.
• ‘People's Perspective’ COVID reports (2020 & 2021) were published alongside the Academy's full COVID-19 policy reports, and bought together a group of diverse patients, people with lived experience of health conditions, and carers across the UK to rapidly review how the UK had to prepare for a challenging winter, considering reasonable worst-case scenarios for rising COVID-19 cases to ensure a core public voice was put forward. 
• The Departure Lounge (2019), was a creative pop-up installation in Lewisham shopping centre, that aimed to engage local and national communities with conversations on death and dying, to help both inform policymakers and end-of-life researchers. The physical installation was deliberately located in an area that has high levels of socioeconomic deprivation, a very diverse local population, and is traditionally underserved by cultural and scientific outreach initiatives.

We are committed to working towards full equality of opportunity both in our own organisation, practices and work, and in the wider academic workforce. See our work towards this here.

In the UK, 51% of the population and 47% of the workforce are women, yet health systems have systematically deprioritised women’s health issues.

• 1 in 10 women worldwide will be affected by miscarriage, and many will never know why.
• In a study of 3000+ women, two in five reported report persistent incontinence 12 years after giving birth.
• 1 in 5 women in the UK sees five or more different midwives during pregnancy.
• Conditions such as endometriosis currently take in the UK on average 8 years to be correctly diagnosed.
• A woman is 50% more likely to receive the wrong initial diagnosis for a heart attack.
• Although Black women are the group most likely to experience a mental health disorder, they are half as likely as white women to receive treatment.
• Over two thirds of women needing personal protective equipment at work reported not having female-shaped or sized personal protective equipment available.
• Women from the richest parts of England live on average 7 years longer than women from the poorest.

We are working to try and change this.

In 2021 we submitted evidence to the Department of Health and Social Care ahead of their development of the UK's first Women's Health Strategy, published August 2022. In 2022 we released a new report on women's health from our symposium with the Royal Society, exploring women's sexual health, the menopause, menstrual health, femtech, endometriosis and more. Find out more and download the full report. 

We also work to directly support women in science through our own career support programmes. Our SUSTAIN programme for women in research takes women in their first independent positions and gives them a year of support within a cohort of peers. In an independent evaluation, 9 in 10 women said SUSTAIN “helped them thrive” as independent researchers. Find out more and explore our wider work on equity, diversity and inclusion.

We have also worked with the African Academy of Sciences to host a workshop on maternal and newborn survival in sub-Saharan Africa. Despite Africa having only 13% of the world’s population, it carries more than half the burden of maternal and newborn deaths, with an African woman facing a 1 in 39 chance of dying from complications in pregnancy or childbirth. Our joint workshop brought together approximately 65 scientists, clinicians, policymakers and funders from 15 countries across sub-Saharan Africa to discuss key research gaps.