Definitions for Health Inequalities

Useful definitions

Please find agreed definitions used in the development of two key resources: the menu of evidence-based interventions for addressing health inequalities and the PHE place based approaches to reducing health inequalities.

Definition of Health Inequalities

Health inequalities are unfair and avoidable differences in health across the population, and between different groups within society.  Health inequalities arise because of the conditions in which we are born, grow, live, work and age. These conditions influence our opportunities for good health, and how we think, feel and act, and this shapes our mental health, physical health and wellbeing.

Health inequalities have been documented between population groups across at least four dimensions, as illustrated in the figure below. It is important to note that these are overlapping dimensions with people often falling into various combinations of these categories.

Examples of the characteristics of people/communities in each of these groups are below (this is not an exhaustive list):

  • Socio-economic status and deprivation: e.g. unemployed, low income, people living in deprived areas (e.g. poor housing, poor education and/or unemployment).
  • Protected characteristics: e.g. age, sex, race, sexual orientation, disability
  • Vulnerable groups of society, or ‘inclusion health’ groups: e.g. vulnerable. migrants; Gypsy, Roma and Traveller communities; rough sleepers and homeless people; and sex workers
  • Geography: e.g. urban, rural.

Action on health inequalities requires improving the lives of those with the worst health outcomes, fastest.

Inclusion Health Groups

Inclusion Health has been used to define a number of groups of people who are not usually well provided for by healthcare services, and have poorer access, experiences and health outcomes. The definition covers people who are homeless and rough sleepers, vulnerable migrants (refugees and asylum seekers), sex workers, and those from the Gypsy, Roma and Traveller communities.

Protected Groups

The protected characteristics covered by the Equality Act 2010 are: age, disability, gender reassignment, marriage and civil partnership (but only in respect of eliminating unlawful discrimination), pregnancy and maternity, race—this includes ethnic or national origins, colour or nationality, religion or belief—this includes lack of belief, sex, sexual orientation

People living in deprived areas

Evidence says that people living in our most deprived areas face the worse health inequalities in relation to health access, experiences and outcomes.  When we talk about deprived areas, in relation to geography, this means we are working to address inequalities in urban and rurally deprived areas of England.

What defines whether an area is a deprived area is based on a number of characteristics included in the index of Multiple Deprivation – Income Deprivation, Employment Deprivation; Education, Skills and Training Deprivation; Health Deprivation and Disability; Crime; Barriers to Housing and Services; Living Environment Deprivation.