Welcome to the latest key papers and publications focussing mainly on health inequalities.
Please click on the links below and enter your OpenAthens username and password to download the full text or contact the library at esth.hirsonlibrary@nhs.net to request the full text.
What are health inequalities?
Abstract: Health inequalities are avoidable, unfair and systematic differences in health between different groups of people. There are many kinds of health inequality, and many ways in which the term is used. That’s why, when we talk about ‘health inequality’, it’s useful to be clear about which measure is unequally distributed and between which people.
Source: Jefferies D. The King’s Fund, Sep 2025
The Equality and Health Inequalities Hub
Abstract: Within this hub you will find information about NHS England’s statutory responsibilities around equalities and health inequalities and the national NHS programmes in these areas.
Programmes work across the NHS and with other agencies, people and communities to advance equalities; and achieve equitable access, excellent experience and optimal outcomes for the people we serve and the colleagues we work with.
Source: NHS England, 2025
Health inequalities hub
Abstract: Our health inequalities hub shines a light on case studies focusing on health inequalities from councils across the country.
Source: Local Government Association, 2025
Reducing health inequalities in your local area: a toolkit for clinicians
Abstract: This toolkit is intended to support clinicians working across the UK.
Source: BMA, Mar 2026
How we Support Reducing Health Inequalities
Abstract: At the TU, we are committed to addressing health inequalities in all areas of our work.
Guided by our enabling ethos and focus on population health, we work with our clients to improve patient health outcomes through inclusive, data-informed approaches. Our commitment to addressing health inequalities and championing equality, diversity and inclusion involve a comprehensive and sustained effort across all our work to ensure fair and equitable health outcomes for all.
Source: Transformation Unit, Aug 2025
Social determinants of health
Abstract: Social determinants of health – broadly defined as the conditions in which people are born, grow, live, work and age, and people’s access to power, money and resources – have a powerful influence on health inequities. These are the unfair and avoidable differences in health status seen within and between countries.
Source: World Health Organisation, 2026
Social security cuts and life expectancy: a longitudinal analysis of local authorities in England, Scotland and Wales
Abstract:
The UK Government's 'welfare reform' programme included reductions to social security payments, phased in over the financial years 2011/2012-2015/2016. Previous studies of social security cuts and health outcomes have been restricted to analysing single UK countries or single payment types (eg, housing benefit). We examined the association between all social security cuts fully implemented by 2016 and life expectancy, for local authorities in England, Scotland and Wales.
METHODS: Our unit of analysis was 201 upper tier local authorities (unitary authorities and county councils: 147 in England, 32 in Scotland, 22 in Wales). Our exposure was estimated social security loss per head of the working age population per year for each local authority, calculated against the baseline in 2010/2011. The primary outcome was annual life expectancy at birth between the calendar years 2012 and 2016 (year lagged following exposure). We used a panel regression approach with fixed effects.
RESULTS: Social security cuts implemented by 2016 were estimated to be 475 per head of the working age population in England, 390 in Scotland and 490 in Wales since 2010/2011. During the study period, there was either no improvement or only marginal increases in national life expectancy. Social security loss and life expectancy were significantly associated: an estimated 100 decrease in social security per head of working age population was associated with a 1-month reduction in life expectancy.
CONCLUSIONS: Social security cuts, at the UK local authority level, were associated with lower life expectancy. Further research should examine causality.
Source: Seaman R. Journal of Epidemiology and Community Health, Feb 2024; 78(2): 82-87
Black maternal health: third report of session 2024–26
Abstract: This report finds that Black women in England face disproportionately poor outcomes in maternity care, shaped by systemic failings in leadership, training, data collection and accountability. The report acknowledges that failings in care for Black women are taking place in the context of a maternity system that is failing women more broadly, with the NHS in England having paid 27.4 billion in maternity negligence since 2019, estimated at, a figure greater than the total maternity budget for the same period.
Source: Moran L. Health and Social Care Committee, Black Maternal Health, 2025
Government response to the Health and Social Care Committee’s third report of session 2024 to 2026: Black maternal health
Abstract: This is the government's formal response to the recommendations made by the Health and Social Care Committee's report on Black maternal health, which was published on 17 September 2025.
Source: Department of Health and Social Care (DHSC), 2025
Monitoring the Mental Health Act in 2024/25
Abstract: This report into the use of the Mental Health Act finds that increasing demand for services and higher thresholds for admission are leading to long waits for mental health care. The report, which was built on interviews with over 3,000 patients and over 700 family members and carers, reveals reoccurring issues of staff shortages, a lack of beds, and inconsistencies in experiences. It also finds that out-of-area placements on the rise even though there was a national commitment to end this practice by March 2021.
Source: Care Quality Commission, 2026
How ICBs are improving men’s health
Abstract: Following the launch of the Men's Health Strategy Kathy Oxtoby takes a look at the state of healthcare for men across the NHS system.
Source: Oxtoby K. Healthcare Leader, Jan 2026
Government response to Lords Select Committee's report 'Time to deliver: The Autism Act 2009 and the new autism strategy'
Abstract: The command paper sets out the government's response to the recommendations made by the House of Lords Autism Act 2009 Committee in their report 'Time to deliver: The Autism Act 2009 and the new autism strategy'. The government welcomes the committee's report and will consider their recommendations further during the development of the next strategy. It also sets out the work government is already doing to support autistic people.
Source: Department of Health and Social Care (DHSC), 2026
Reducing inequalities in cancer care: a health system approach to implementing change
Abstract: The brief highlights why inequalities remain a major barrier to progress, and why a broad health systems approach matters. It sets out practical actions across governance, financing, service delivery and workforce to translate scientific advances into more equitable outcomes.
Source: Myers C. European Observatory on Health Systems and Policies, 2025
Trends in educational inequalities in smoking-attributable mortality and their impact on changes in general mortality inequalities: evidence from England and Wales, Finland, and Italy (Turin)
Abstract:
BACKGROUND: Socioeconomic mortality inequalities are persistent in Europe but have been changing over time. Smoking is a known contributor to inequality levels, but knowledge about its impact on time trends in inequalities is sparse.
METHODS: We studied trends in educational inequalities in smoking-attributable mortality (SAM) and assessed their impact on general mortality inequality trends in England and Wales (E&W), Finland, and Italy (Turin) from 1972 to 2017. We used yearly individually linked all-cause and lung cancer mortality data by educational level and sex for individuals aged 30 and older. SAM was indirectly estimated using the Preston-Glei-Wilmoth method. We calculated the slope index of inequality (SII) and performed segmented regression on SIIs for all-cause, smoking and non-SAM to identify phases in inequality trends. The impact of SAM on all-cause mortality inequality trends was estimated by comparing changes in SII for all-cause with non-SAM. RESULTS: Inequalities in SAM generally declined among males and increased among females, except in Italy. Among males in E&W and Finland, SAM contributed 93 per cent and 76 per cent to declining absolute all-cause mortality inequalities, but this contribution varied over time. Among males in Italy, SAM drove the 1976-1992 increase in all-cause mortality inequalities. Among females in Finland, increasing inequalities in SAM hampered larger declines in mortality inequalities.
CONCLUSION: Our findings demonstrate that differing education-specific SAM trends by country and sex result in different inequality trends, and consequent contributions of SAM on educational mortality inequalities. The following decades of the smoking epidemic could increase educational mortality inequalities among Finnish and Italian women.
Source: Van Hemelrijck Wanda Monika J. Journal of Epidemiology and Community Health, Sep 2024; 78(9): 561-569
Time for action: introduction of a national planning policy to promote a healthier food environment in England
Abstract: This article is a commentary on the National Planning Policy Framework, published in December 2024 by the Ministry of Housing, Communities and Local Government (MHCLG), which breaks new ground in relation to policy on hot food takeaways and fast-food outlets with reference to health inequalities and outlines its relevance to public health as part of a whole systems approach to obesity and overweight.
Source: Bannerman A. Perspectives in Public Health, Sep 2025; 145(5): 243-245
Contact the library for a copy of this article
Equitable inclusion of patients with cancer on the palliative care register: a systematic review in primary care
Abstract:
Background: GPs are instrumental to palliative care in the UK and most practices maintain a register of patients with palliative care needs. However, many people with incurable cancer who could benefit from palliative care are not included on this register, making this a potential source of end-of-life inequity.
Aim: To identify barriers and facilitators to recognising the palliative care needs of patients with cancer in the UK and understand how these factors may have an impact on those vulnerable to end-of-life inequity.
Design and setting: A mixed-methods systematic review. Method Eight electronic databases (Alternative Medicine, CINAHL, Embase, Medline, PsycINFO, Scopus, SocINDEX, and Web of Science) and two preprint servers (medRXiv and Open Science Framework) were searched in November 2024. Qualitative, quantitative, and mixed-methods studies were included. Narrative synthesis was used to integrate study findings, with resulting barriers and facilitators mapped onto the COM-B model domains of capablity, opportunity, and motivation. The impact on equity was evaluated using the PROGRESS-Plus framework.
Results: Searches returned 7190 citations, with 24 studies included in the review. Seven themes were identified, with barriers and facilitators mapped onto COM-B domains: conceptualisation of palliative care; navigating challenging conversations; healthcare organisation; patient help-seeking; time and resource constraints; perceptions shaping practice; and cognitive associations. There was insufficient evidence about the barriers and facilitators that may be having an impact on those vulnerable to end-of-life inequities.
Conclusion: GPs experience many barriers to recognising palliative care needs. There is a need for greater understanding of the extent and nature of inequities in recognising such needs, to ensure strategies to increase recognition do not widen inequities.
Source: Henderson R. British Journal of General Practice, Oct 2025; 75(759): e659-e668
From policy to action: a document content analysis reviewing the adoption of the healthcare inequalities programme in local health system plans in England
Abstract:
OBJECTIVES: This analysis aimed to explore how local health system strategies and plans seek to tackle health and care inequalities and address national policies. Specifically, the analysis considered alignment with five national priority areas: restoring services inclusively, mitigating digital exclusion, ensuring the completeness and timeliness of datasets, accelerating preventative programmes and strengthening leadership and accountability. In addition, the analysis explored the extent to which systems are engaging with the Core20PLUS5 approach, which targets the most deprived 20 per cent of the population ('Core 20') and population groups experiencing disproportionately poor access, outcomes or experiences of care ('PLUS').
DESIGN AND SETTING: Integrated care systems (ICSs) are statutory partnerships that bring together healthcare, social care, local government and wider system organisations to collaboratively address the root causes of ill health and health inequalities. We conducted a document analysis of available ICS strategies, 5-year plans and health inequalities plans published in England between 1 January 2022 and 31 July 2023. A total of 43 strategy documents, 38 5-year plans and seven health inequalities plans were analysed. A data extraction framework was used to guide reviewers and independent quality assurance was completed to ensure internal validity, intrarater reliability, and reproducibility of the project.
RESULTS: the analysis highlighted good alignment with national healthcare inequalities policies and local approaches to tackling healthcare inequalities, with the majority of systems citing the Core20PLUS5 framework. There was notable variation between systems on the adoption of the framework with the children and young people's framework being less widely considered than the adult's framework. Across systems, equity-focused tools were widely used, and numerous systems had developed outcome frameworks to monitor progress. Leadership for health inequalities was strengthened with senior leadership roles being established to hold integrated care boards accountable for improving access, experiences and outcomes. However, competing priorities, particularly concerning implementations of new organisational models and multiple national priorities, were evident within the plans which may challenge progress on reducing health and healthcare inequalities.
CONCLUSIONS: The review concluded that while progress has been made in adopting national healthcare inequalities policies and steers, significant variation exists between systems, possibly reflecting local population needs and varying levels of maturity of the systems across England. The review highlights the need for further evaluations at both national and local levels, allowing for further development of the systems. Additionally, consistent and sustainable funding and more robust training for health inequalities leadership roles is needed to ensure equitable access, experience and outcomes.
Source: Elliott H. BMJ Open, Oct 2025; 15(10): e102163
The Maternal Care Bundle: a care bundle for reducing maternal mortality and morbidity
Abstract: The Maternal Care Bundle (MCB) sets best practice standards across five areas of clinical care, for implementation by NHS providers and commissioners across England. The aim is to reduce maternal mortality and morbidity and reduce inequalities in these adverse outcomes.
Source: NHS England, 2026
Chronic pain: prevalence, demographic inequalities, and healthcare utilisation: a primary care database analysis
Abstract:
BACKGROUND: Chronic pain (CP) is an ill-defined condition, often under-recorded in primary care records.
AIM: To determine prevalence, evidence of health inequalities, primary care consultation rates, and healthcare utilisation costs of CP.
DESIGN & SETTING: Cross-sectional, retrospective study using anonymised primary care data from all GP practices in one inner-city London area.
METHOD; CP was defined on the basis of analgesic medication codes and novel inclusion of diagnostic codes for conditions known to be strongly associated with CP. CP prevalence and consultation rates were determined; comparisons were made with 31 other long-term conditions (LTCs). Consultation cost estimates were based on healthcare professional type and consultation mode.
RESULTS: In total, 358 889 adult patients were registered in sample practices, with continuous (12-month) healthcare records available for 327 800 (91.3 per cent). CP prevalence was 18.6 per cent; the second most prevalent LTC after anxiety at 21.4 per cent. CP mean annual consultation rates were 15.3 per patient, the highest LTC consultation rate. CP incurred the highest primary care consultation costs of any of the included LTCs. Age was the strongest predictor of CP, particularly in those aged >=60 years (adjusted odds ratio [AOR] for 60-69 years: 9.32; 95 per cent confidence interval [CI] = 8.83 to 9.84; compared with those aged 18-29 years). Much smaller AORs were found for ethnicity, social deprivation, sex, and non-UK country of birth.
CONCLUSION: CP represents the most demanding LTC, in terms of consultation rates and costs, managed in primary care. Yet there is considerable uncertainty about optimal management and alternatives to long-term, high-volume primary care consultation rates.
Source: Shetty S. BJGP Open, Oct 2025; 9(3): BJGPO.2024.0147
Locked out: exclusion of deaf and deafblind BSL users from health and social care in the UK
Abstract: This report presents the findings and recommendations of the BSL Advisory Board's Health and Social Care sub-group. The report examines the barriers that BSL users face in navigating the UK's health and social care systems. The report highlights the higher levels of health and social care needs within the deaf and deafblind BSL user communities, as well as the resulting health inequalities. It details how persistent challenges, such as inaccessible communication systems and a lack of qualified interpreters, lead to economic costs and cumulative trauma for BSL users. The BSL Advisory Board puts forward twelve essential priorities and additional areas for action designed to create a more inclusive and equitable future. The aim of these recommendations is to unlock access to services, improve health outcomes, and provide a strong return on investment by reducing avoidable costs in the NHS and social care budgets.
Source: Disability Unit, 2025
Recruitment, retention and reporting of ethnic representativeness in maternity trials: a scoping review
Abstract:
INTRODUCTION: Black and Asian women experience significantly higher rates of mortality and morbidity perinatally compared with white women and are more likely to lose their babies. These groups are also under-represented in clinical research, resulting in evidence that may not be generalisable. Tools have been developed to facilitate the inclusion of ethnic minority groups, but it is unknown to what extent representation and inclusion are considered in maternity trials. AIM: To provide an overview of how ethnically diverse recruitment is considered and reported in maternity trials in the UK.
METHODS: A scoping review was conducted, undertaking a systematic search to identify published trial protocols and their subsequent results papers, conducted within the UK, recruiting women during pregnancy or within six weeks postnatally between 2004 and 2024. Data was extracted from protocols on whether representation of participants was considered in the study design and if specific recruitment and retention strategies were planned for ethnic minority groups. Data extracted from results papers identified whether representation of participants was discussed and if recruitment strategies were discussed; these were compared against the protocol.
RESULTS: A total of 96 published protocols met the inclusion criteria; eight mentioned specific recruitment strategies and 5 mentioned specific retention strategies. Only two included both recruitment and retention strategies. The most common strategies included providing different types of language support and adapting interventions to be culturally appropriate. Strategies were not evaluated. 67 results papers were available. Ethnicity was reported in 57 papers, with heterogeneity of categories between papers. Only 32 papers discussed representativeness of participants.
CONCLUSION: Few maternity trials report considerations on how they ensure they are recruiting and retaining ethnically representative participants. Minimal discussion is undertaken around the extent to which trial participants reflect the population to which findings will be applied. Further work is needed to support implementation and evaluation of inclusive research guidance. Failing to ensure those from ethnic minority groups are included in research can exacerbate inequalities.
Source: Lovell H. BMJ Open, 2025;15(11): e098926
Integrated care systems and strategic authorities: coming together to tackle health inequalities and the wider determinants of health
Abstract: This essay was written by the Centre for Local Economic Strategies and The King's Fund, as part of a programme of work commissioned by The Health Foundation. Strategic authorities and integrated care systems are increasingly powerful entities with the potential to tackle health inequalities and improve population health. However, achieving this will require them to work together effectively. This essay explores the changing policy context in which these bodies exist, and the way the dynamics between them could and should evolve as devolution beds in.
Source: Tiratelli L. Centre for Local Economic Strategies (CLES), 2025
Equalities impact assessment: 10 Year Health Plan for England
Abstract: This equality impact assessment (EQIA) assesses how the Department and Health and Social Care (the department) and NHS England have worked in partnership to address the requirements of the public sector equality duty, section 149(1) of the Equality Act 2010, and related provisions under section 149 more generally, in developing the 10 Year Health Plan. It also highlights if risks have been identified that need to be mitigated as proposals are implemented. The EQIA incorporates assessments for each chapter of the plan which explores the proposals through the lens of each protected characteristic.
Source: Department of Health and Social Care (DHSC), 2025
Technical guide to allocation formulae and convergence for 2026/27 to 2028/29 revenue allocations
Abstract: This is a technical guide to allocation formulae and convergence for the 2026/27 to 2028/29 revenue allocations. The guide provides detailed information on the technical approach to the 2025/26 revenue allocations.
Source: NHS England, 2025
Strategies to improve telehealth access for culturally and linguistically diverse communities: a systematic review
Abstract:
AIMS: CaLD populations face considerable digital health inequities; strategies are needed to ensure telehealth models of care are available to all. We aimed to identify and describe interventions that enhance telehealth access for CaLD communities.
METHODS: We systematically searched four databases (PubMed, Scopus, Embase, and CINAHL). Included studies were published between 2011 and 2024 and reported on at least one of the outcomes described in the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework. Two authors independently screened articles, solutions were synthesized qualitatively.
RESULTS: Twenty-seven articles were included in the review and primarily used videoconferencing as the predominant telehealth modality (n = 14, 52 per cent). Five strategies were identified to promote telehealth use across CaLD communities including: (i) Provide bilingual options; (ii) Enhance staff cultural competence; (iii) Provide flexible adaptions to align with consumer needs; (iv) Supply technology and technological support; and (v) Involve digital health navigators and/or health educators.
CONCLUSIONS: Culturally competent professionals supported by language services and technological support are strategies which can help improve equity of access to telehealth services for people from CaLD communities. Such strategies can support the implementation of practical solutions to overcome health inequities and prevent access gaps.
Source: Gallegos-Rejas Victor M. Journal of Public Health, Sep 2025; 47(3): e374-e390
Starting behind, staying behind: the opportunity gap facing boys from low-income families at age 5 and beyond
Abstract: This report looks beneath the headline data to focus on one group particularly at risk of being overlooked, or under-served, by policy making from an early age: boys from low-income families. It provides a data-driven picture of the opportunity gap facing this group at age five and beyond, the root causes of attainment gaps and how these are linked to systemic failings in the way government works.
Source: Metcalfe S. Institute for Government, 2025
Exploring ethnicity data use and gaps in health care
Abstract: This report identifies the barriers to the collection, availability and use of quality ethnicity data and opportunities and best practice to overcome these barriers. It makes recommendations to leverage existing ethnicity data sets and proposes long-term steps to build coherent and equitable data systems capable of driving real change.
Source: Butt J. Race Equality Foundation, 2025
Independent review into mental health conditions, ADHD and autism: terms of reference
Abstract: This publication sets out the terms of reference for an independent review into the prevalence, trends and inequalities associated with mental health conditions, ADHD and autism in children, young people and adults. The review will seek to understand: the factors behind trends in prevalence, the impact of clinical practice, including social and cultural factors and the risks and benefits of medicalisation, ways to promote the prevention of mental ill health, and ways to create resilience and improve early intervention.
Source: Department of Health and Social Care (DHSC), 2025
Tackling health inequalities together: inclusion health and co-production
Abstract: Trauma-informed approaches acknowledge the impact of trauma on the health of patients and staff, and the ways in which health care is accessed and experienced. There is growing interest in these approaches in both a UK and international primary care context. Intrinsic to a trauma-informed approach (although rarely achieved in practice) is the co-production of health services with those with relevant lived experience. Existing models of patient involvement in primary care tend to rely significantly on feedback forms or surveys, which do not facilitate an ongoing dialogue between patients and healthcare providers. Patient participation groups (PPGs) can provide a more meaningful space in which services can be truly co-produced, in particular where careful attention is given to power dynamics in the room. There is, however, an increasing understanding of the need for flexibility in our approaches to patient involvement, which should incorporate multiple models, recognising individuals' diverse experiences, preferences, and capacity for participation. The Care Quality Commission (CQC) suggests that we may have'... more effective conversations through engaging with different community groups at different times and in different places'. The need for provision of protected spaces with careful attention to sociocultural backgrounds and power dynamics is echoed within the principles of trauma-informed care. The current authors have worked proactively with specific community groups who are often poorly served by our health services. We have sought to create protected spaces and mitigate existing power dynamics to support the free communication of ideas, working together with partnership organisations to improve local primary care provision.
Source: McGeown H. British Journal of General Practice, Oct 2024; 74(747): 469-471
A realist review of how, why, for whom and in which contexts quality improvement in healthcare impacts inequalities
Abstract:
INTRODUCTION: Quality improvement (QI) is aimed at improving care. Equity is one of the six domains of healthcare quality, as defined by the Institute of Medicine. If this domain is ignored, QI projects have the potential to maintain or even worsen inequalities.
AIMS AND OBJECTIVES: We aimed to understand why, how, for whom and in which contexts QI approaches increase, or do not change health inequalities in healthcare organisations.
METHODS: We conducted a realist review by first developing an initial programme theory, then searching MEDLINE, Embase, CINAHL, PsychINFO, Web of Science and Scopus for QI projects that considered health inequalities. Included studies were analysed to generate context-mechanism-outcome configurations (CMOCs) and develop an overall programme theory.
RESULTS: We screened 6259 records. Thirty-six records met our inclusion criteria, the majority of which were from the USA. We developed CMOCs covering four clusters: values and understanding, resources, data, and design. Five of these described circumstances in which QI may increase inequalities and 15 where it may reduce inequalities. We found that QI projects that are values-led and incorporate diverse, patient-led data into design are more likely to address health inequalities. However, when staff and patients cannot engage fully with equity-focused projects, due to practical or technological barriers, QI projects are more likely to worsen inequalities.
CONCLUSIONS: The potential for QI projects to positively impact inequalities depends on embedding equity-focused values across organisations, ensuring sufficient and appropriate resources are provided to staff delivering QI, and using diverse disaggregated data alongside considered user involvement to inform and assess the success of QI projects. Policymakers and practitioners should ensure that QI projects are used to address inequalities.
Source: Johnson Lucy L. BMJ Quality and Safety, Aug 2025; 34(8): 537-546
Understanding health inequalities research capacities: insights and recommendations from comparing two high income settings
Abstract: Generating evidence on health inequalities (HI) is necessary to raise awareness of these issues, describe and monitor their evolution, analyze their causes, and inform interventions aiming to improve health equity. Yet not all cities and countries have the capacity to produce this type of research. Recent research provides new contextual and causal insights into this research production process, and in-depth understanding on why and how this type of research is produced in certain settings. This article aims to analyze two recent case studies that have uniquely explored this process in two high producers of HI research and high-income country settings to identify learning and distil recommendations, which may be insightful for other settings. Expanding and investing in this line of research is critical, particularly in places with lower HI research output and related capacity, in order to identify key contextual conditions and mechanisms that may enable or hinder this process. This new knowledge could guide the development of new HI research capacity strengthening strategies to foster this research in different settings, worldwide. More understanding is also needed on the relationship between HI research, policy, and action in order to tackle HI.
Source: Cash-Gibson L. International Journal of Social Determinants of Health and Health Services, Apr 2024; 54(2): 163-170
The U-shaped curve of health inequalities over the 20th and 21st centuries
Abstract: This article examines historical trends in health inequalities over the 20th and 21st centuries. Drawing on studies from the United States, United Kingdom, Sweden, and Western Europe, it concludes that there is evidence of a u-shaped curve in (relative) health inequalities. These trends in health inequalities broadly parallel those identified by economists with regards to the u-shaped curve of income and wealth inequalities across the 20th and 21st centuries. The article argues that-as with income inequalities-health inequalities generally decreased across the twentieth century through to the early 1980s. They then started to increase and accelerated further from 2010, particularly in the United Kingdom and the United States. The article sets out four distinct policy periods that shaped the evolution of trends in health inequalities: the Interbellum Era, 1920-1950; the Trente Glorieuse, 1950-1980; Neoliberalism, 1980-2010; and the Crisis Age, 2010-present. The u-shaped curve of health inequalities over this period suggests that social policies, health care access, and political incorporation have driven changes over time. Taking this long view of changes in health inequalities emphasizes the importance of politics and policy for future health improvement.
Source: Bambra C. International Journal of Social Determinants of Health and Health Services, Jul 2024; 54(3): 199-205
What is the state of children's health in England?
Abstract: This explainer offers a snapshot of the current state of children's health in England, drawing on the latest available evidence. It focuses on outcomes across physical and mental health, the inequalities and wider determinants that shape those outcomes, and how well the health and care system is responding. It closes with The King's Fund's view on priorities for action and a look ahead to the second explainer, which will map the system for children and young people in England - setting out who is responsible for what, how services are delivered, and the levers available to improve outcomes and reduce inequalities.
Source: Buckingham N. The King’s Fund, 2025
Health for wealth 2025: building a healthier North to boost UK productivity
Abstract: This report reveals that the relationship between health and productivity has become stronger over the last seven years, placing a huge financial burden on the economy and stagnating possible productivity growth. It finds that the scale of health-related economic inactivity is greater in the North of England, with workers more likely to lose their job due to ill health, and those without educational qualifications facing a ninefold higher risk of losing their job if they become ill.
Source: Simpson J. Northern Health Science Alliance, 2025
Affordable infrastructure: how strategic authorities can use housing and public transport to tackle health inequalities
Abstract: This essay was written by the Centre for Local Economic Strategies and The King's Fund, as part of a programme of work commissioned by The Health Foundation. Housing and public transport are critical determinants of health. Strategic Authorities (SAs) are uniquely positioned to influence the affordability of homes and transport - the levers available to them offer promising potential to reduce health inequalities, particularly for those on the lowest incomes. This essay draws on conversations with mayors and SA officers to highlight how innovative housing and transport policies like municipal housebuilding and bus franchising can be scaled and amplified to achieve greater impact on narrowing health inequalities.
Source: Goodwin Tom L. Centre for Local Economic Strategies (CLES), 2025
Structural racism as a fundamental cause of health inequities: a scoping review
Abstract:
BACKGROUND: Structural racism is increasingly recognized as a fundamental cause of health inequities. It operates through laws, institutional policies, and systemic practices that disproportionately disadvantage racially and ethnically minoritized populations. Although the body of evidence on structural racism and health is expanding, much of it remains fragmented across disciplines and sectors. This scoping review synthesized peer-reviewed research by examining the pathways through which structural racism affects health, the most frequent outcomes, and the interventions and policies implemented to address these disparities.
METHODS: The review adhered to frameworks by Arksey and O'Malley, Levac et al., and the Joanna Briggs Institute. Six databases (MEDLINE, Embase, Web of Science, CINAHL, PsycINFO, and Scopus) were searched for English-language, peer-reviewed studies published before February 15, 2025, examining structural, systemic, or institutional racism in relation to health. Two reviewers independently screened and extracted data, and findings were analyzed using thematic synthesis.
RESULTS: Eighty-three studies met the inclusion criteria, covering healthcare, housing, the criminal legal system, environmental exposures, and other intersecting sectors. Structural racism was consistently associated with adverse outcomes in maternal and infant health, cancer, cardiovascular disease, HIV care, mental health, and COVID-19. Key mechanisms included redlining, residential segregation, carceral practices, discriminatory clinical treatment, and environmental injustice. Intersectional burdens were most pronounced among Black, Indigenous, LGBQ, immigrant, and socioeconomically marginalized groups. Although some promising interventions were identified, including culturally tailored perinatal care, community health worker models, and equity-focused quality improvement, few had been rigorously evaluated or embedded in broader structural policy changes.
CONCLUSION: Structural racism was found to operate across institutional and societal systems to perpetuate health disparities. While targeted interventions show promise, significant gaps remain in the development and implementation of scalable, evidence-based reforms. To achieve health equity, public health strategies must prioritize cross-sectoral actions for confronting and dismantling the structural conditions that maintain racial injustice. This synthesis highlights the urgent need for scalable policy reforms and structural accountability measures across sectors.
Source: Kisa A. International Journal for Equity in Health, Oct 2025; 24(257)
Public health under threat: how our leadership must evolve in complex and uncertain times
Abstract: Public health professionals across the UK and around the world are currently grappling with a landscape of unprecedented complexity. Long-standing systemic challenges across the UK have led to stagnating-even declining-life expectancy and widening health inequalities, whilst on a global scale the very foundations of evidence-based public health programs and principles are under threat. Our leadership as public health professionals must evolve in response to these mounting challenges. We need a new paradigm in public health, one that embraces the interconnected nature of modern threats to health, and one that is disruptive, agile, collaborative, and firmly rooted in principles of equity and justice. The world is changing rapidly, and public health leadership must adapt to meet the challenges of a more interconnected and dynamic environment. Many of the population-level health challenges facing the UK stem from the deep-rooted social and economic inequalities faced by communities across England, Scotland, Wales, and Northern Ireland. That life expectancy has recently declined in some of the UK's most deprived areas speaks to a long-term failure to properly support our most vulnerable populations, including marginalized minority ethnic communities.
Source: Fenton K. Journal of Public Health, Jun 2025; 47(2): 111-113
