Health Inequalities Manifesto 2018 presents actions to address mental health inequalities across England

Mental Health FoundationMarch 2018 | Health Inequalities Manifesto 2018 

Health Inequalities Manifesto 2018 is a new publication from the Mental Health Foundation, it underlines how certain population subgroups are at higher risk of mental health problems. This is a result of  of greater exposure and vulnerability to unfavourable social, economic, and environmental circumstances:

  • Material inequality – poverty, poor housing, lack of employment opportunities.
  • Social inequality and injury – stigma and discrimination or experiences related to:
    • living in care
    • immigration status
    • ethnicity
    • sexual orientation
    • disability
    • experience of violence or abuse.
  • Health inequality – including having long-term physical health conditions.
Mental health inequal
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The Mental Health Foundation recognise a social gradient which exists in relation to poverty and/or economic  inequality and poorer mental health and wellbeing. Populations living in poor socio-economic circumstances are at increased risk
of poor mental health, depression and lower wellbeing. They advocate particular approaches and interventions to reduce the risk factors underpinning inequalities and applying these proportionately across the social gradient.

Their review of the latest evidence about how to lessen the risk of mental health  inequalities has enabled the to identify five priorities for action.  The manifesto  presents these actions that can be applied to address mental health inequalities in England. These are:

  1. Healthy children: Promote emotional wellbeing and build resilience from birth through universal and targeted programmes..
  2. Healthy minds:  Introduce a comprehensive and multi-sectoral approach to address mental health promotion, prevention, treatment, discrimination, exclusion, care and recovery.
  3. Healthy places: Apply a socio-ecological approach that takes account of the impact of the social and physical environment, within homes and in settings such as schools and communities.
  4. Healthy communities: Introduce a place-based approach to protect and support good mental health and wellbeing in the community.
  5. Healthy habits: Give people the knowledge, tools and resources to protect and improve their own and their families’ and friends’ mental health.

The full manifesto can be downloaded from the Mental Health Foundation 

Healthy lives

The Local Government Association has published a series of documents relating to Public Health:

All-Party Parliamentary Group (APPG) report on breast cancer finds inequalities in diagnosis, treatment and care based on where you live

All-Party Parliamentary Group on Breast Cancer | A Mixed Picture: An Inquiry into Geographical Inequalities and Breast Cancer | 2018

A Mixed Picture: An Inquiry into Geographical Inequalities and Breast Cancer has found that people in England are experiencing differences in their diagnosis, care and treatment due to their location rather than their clinical need. In response to this the APPG ran an inquiry from October 2016 to November 2017 to discover where and why inequalities arise and what the possible solutions might be.

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Evidence presented to the inquiry showed some innovative and high performing services, but  unacceptable differences exist at every level of geography. Some regions of the country perform better in certain areas of care or treatment than others. Stark differences in the availability of services can also occur within very local geographies, from town to town or even within individual towns and cities.

This report outlines key recommendations to address these disparities, the authors call on NHS England and Public Health to address these inequalities through better workforce planning and data collection; as well as calling for  improving the consistency, transparency and accountability of commissioning and delivery of cancer services through new NHS improvement and structures.

The report can be read here 


Deprivation strongly linked to mortality

Report from the Office for National Statistics reveals “sizeable and highly significant” absolute and relative inequalities in avoidable mortality between those living in the most and least deprived areas.


Main points

  • Avoidable, amenable and preventable mortality is strongly related to area deprivation in England and in Wales.
  • In England in 2015 there were 16,686 deaths from avoidable causes in the most deprived areas whereas there were less than half that number (7,247 deaths) in the least deprived areas.
  • In the most deprived areas of Wales there were 1,054 deaths from avoidable causes in 2015, compared with 509 deaths in the least deprived areas.
  • Absolute and relative inequalities in avoidable mortality between those living in the most and least deprived areas were sizeable and highly significant, but the excess was larger for males than females in all cases.
  • The largest relative inequality in avoidable mortality was for deaths from respiratory diseases which were 4.8 times (males) and 7.7 times (females) more likely in the most deprived populations compared with the least deprived.
  • The largest absolute difference in avoidable mortality between the most and least deprived deciles was from cardiovascular disease and cancer.

Full report: Measuring Socioeconomic inequalities in avoidable mortality in England and Wales: 2015

Variation in access to healthcare

The Medical Technology Group has published The north–south NHS divide: how where you are not what you need dictates your care.

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This report examines CCG indicators to find how effective CCGs are at giving patients access to medical technology.  Providing each CCG with a grading based on how they scored in comparison to other CCGs, the report finds wide variation in access between the north and south of England and argues that CCG performance against access indicators should be clearer to patients.

Additional link: The Medical Technology Group press release

Bridging The Health Care Gap Through Telehealth

This case study looks at two telehealth models in Mexico and the U.S. targeting low- to middle-income parts of the population | Commonwealth Fund

health gap

In many developing nations, the public health system is unable to meet demand for services, driving people to seek costly services in the private sector. Telehealth can expand access to care while, in some cases, reducing unnecessary use of services, such as immediate acute care for non–health emergencies.

Using a call centre as the point of access, these models have reduced unnecessary use of services and supported patient navigation of local health services.