Our population, health services, and economy are all being failed by a lack of urgent action to address growing health inequalities. Stark inequalities affect the length of our lives, the health conditions we develop, and our access to healthcare services. These disparities are an injustice that cannot be allowed to continue, and doctors are no longer able to keep picking up the pieces of systemic failures; tangible, decisive action is needed now.

Further webpages on inequalities in the devolved nations are currently under development and links to them will be published here later in 2026.

Recommendations

The UK Government has set goals of halving the gap in healthy life expectancy between the richest and poorest regions, while increasing it for all, and raising the healthiest generation of children in the UK’s history. These goals are accompanied by three desired shifts in care, one of which is the shift ‘from sickness to prevention’ by addressing the social determinants of health.

To achieve these goals and reduce the deep inequalities affecting the population’s health, the BMA is calling on the UK Government and its associated bodies to:

The state of health inequalities in the UK is an injustice that must be urgently addressed; doctors are no longer able to keep picking up the pieces of systemic failures

Health inequalities are unjust and preventable differences in health between groups in society. No group is homogeneous, and individual experiences will be shaped by the ways in which a range of factors intersect. 

In addition to being a moral injustice, health inequalities have a significant impact on the NHS and the ability of overstretched staff to continue meeting growing demand. Doctors have told us they feel powerless to help their most vulnerable patients; they have been trying to pick up the pieces of successive governments’ failure to protect our health, but the systemic issues extend far beyond what an individual doctor can address. Health inequalities are also costly for the economy, with Public Health England estimating in 2021 that they cost taxpayers £68bn (£82bn in 2025/26 prices).

This page presents a snapshot of health inequalities in England. It is shaped by limitations in the data available; many inequalities are not adequately monitored and are therefore not able to be included in this analysis. Data is most commonly available for deprivation; however, the analysis should be interpreted with an intersectional lens, for example ethnic minorities are more likely than White British people to live in deprived neighbourhoods.

Life expectancy and quality unfairly depend on circumstance

The effects of poverty are far-reaching and profound. The lives of people in more deprived areas of England are being cut short, and a greater proportion of their lives are spent in worse health than those in less deprived areas. Those in Blackpool, for example, can expect to spend 51.8 years (men) and 52.9 years (women) of their life in good health, compared to those in Wokingham who can expect good health for 69.7 and 70.8 years respectively – a difference of almost two decades.

While life expectancy estimates continue to be impacted by increased mortality during the Covid-19 pandemic, this impact is not equally distributed as those in the most deprived areas of England saw a more pronounced decrease in life expectancy during 2020 - 2022.

As outlined below, these disparities are reflected in the prevalence of certain conditions.

Condition prevalence is much higher for some population groups

The impact of poverty on the prevalence of health conditions further highlights the effects of persistent health inequalities across England. Evidence shows that multimorbidity (having multiple health conditions at once) is more prevalent in the most deprived areas and varies by ethnicity, with the highest rates among Bangladeshi, Pakistani, and Black Caribbean people.

Our analysis of health conditions below reveals the unequal burden of ill-health and illustrates how socioeconomic disadvantage contributes to poorer health outcomes. These examples are chosen based on available data and reflect a broader pattern of inequality seen across many other conditions. 

• As demonstrated in the below graphs, the prevalence of obesity is higher in more deprived areas. The prevalence of childhood obesity tends to be higher among boys and some ethnic minority groups.
• The prevalence of diabetes in the most deprived areas is 2.5 times the prevalence in the least deprived areas. Across all deprivation quintiles, men have a higher prevalence of diabetes than women.
• The percentage of those reporting a long-term musculoskeletal condition, which affect the joints, bones, muscles and spine (e.g. arthritis, osteoporosis, back pain) is 21% higher in the most deprived areas than in the least deprived areas. There is a gender difference, with 28% more women reporting musculoskeletal conditions than men.
• Diagnoses of certain cancers, such as lung and cervical cancer, are not equally prevalent in the population. There are over 2.5 times as many people with lung cancer and 66% more people with cervical cancer in the most deprived areas compared with the least deprived areas. 

Poverty also affects mental health; the prevalence of common mental health disorders is 74% higher in the most deprived areas and the number of people accessing help from mental health services is also higher, however people are not always getting the help that they need due to insufficient funding and staffing. People who identify as LGBTQIA+ are more likely to experience poor mental health and are at higher risk of suicidal behaviour and self-harm. Asylum seekers and refugees are also at higher risk of mental ill-health; they are exposed to violence and trauma which increases their risk of PTSD (Post-Traumatic Stress Disorder), depression, anxiety disorders and suicidal ideation. 

The prevalence of these conditions and of mental ill-health has dire consequences. Beyond the impact on quality of life, these inequities also contribute to higher rates of premature death from largely preventable or treatable causes.

There are disproportionate rates of death from preventable or treatable causes

The foundations of good health start before birth and in the early years of life, particularly in the first 1,001 ‘critical days’ from conception to age two. Far from starting life from a level playing field, stark inequalities affect health even prior to birth and continue to affect all aspects of both our lives and our deaths. As seen in the examples below, a person’s wealth, gender, ethnicity, disability and other characteristics are linked with their likelihood of death from preventable or treatable causes:

• Those in the most deprived areas have a 36% higher suicide rate than those in the least deprived areas, and men are three times more likely to die by suicide than women.
• People with a learning disability are almost twice as likely to die from preventable causes than the general population.
• Rates of premature death (aged under 75) from cardiovascular disease in the most deprived areas are 3.5 times the rates in the least deprived areas.
• It is estimated that nearly 40% of cancer cases in the UK are preventable due to being caused by known, modifiable risk factors. However, deaths from all cancers in the most deprived areas are around 18-19% higher than the rates in the least deprived areas.
• Rates of infant (under 1 year old) mortality are far higher among all ethnic minority groups compared to White British people, while those in the most deprived areas experience significantly higher rates of both infant mortality and stillbirths. Research suggests a strong link between infant mortality, poverty and social disadvantage.
• Rates of maternal mortality (during or up to six weeks after pregnancy) are 88% higher in the most deprived areas compared to the least deprived areas, and are 2.3 times higher for Black women compared to White women. Black women frequently experience disproportionately worse outcomes in maternity care, and data collection on ethnicity and maternal morbidity must be improved in order to investigate the true extent of this inequality.

Access to public health and healthcare services is not equal or fair

The NHS is in crisis and facing some of the most severe pressures in its history. Everyone has the right to high-quality healthcare, yet there are disparities in access to public health and healthcare services that both stem from and further reinforce health inequalities. This is known as the inverse care law – people who are the most in need of healthcare are the least likely to receive it. 

Some of these inequalities - spanning preventative health services, primary care and secondary care – are outlined below. Critically, there are many other inequalities affecting access to health services, including institutional racism, transphobia, and barriers faced by those experiencing homelessness where a lack of routinely published data prevents an in-depth analysis of the ways in which these inequalities manifest. A wide range of groups also face digital exclusion, which exacerbates health inequalities by making it more challenging to access and navigate care.

There have been disproportionate cuts to preventative health services

In England, local preventative health services such as sexual health services, smoking cessation, drug and alcohol services and children’s health services are largely funded via an annual public health grant allocated to Local Authorities. This funding has not kept up with growing demands and, despite often having the greatest health needs, the most deprived Local Authorities have on average experienced significantly larger funding cuts per person compared to the least deprived Local Authorities (see graph below). Similarly, recent analysis found that deprived areas with the greatest health needs have been the worst hit by pharmacy closures in the last three years.

Access to primary and community care is not equal

Primary and community care play a critical role in the prevention of ill health through the early detection and management of potential health problems. It is vital for this care to be available to all who need it, yet people living in the most deprived areas face unequal access due to these services having inadequate funding to meet demand. For example, as shown in the graph below, there are deprivation differences in the uptake of cancer screening, with the most deprived areas having lower rates of uptake for both cervical and bowel screening. In primary care, GP practices in the most deprived areas of the UK have a larger number of patients per GP (see graph below), alongside less funding per needs-adjusted patient, compared to more affluent areas. The BMA regularly monitors wider pressures in primary care, including the number of GPs, appointments per month, and the GP to patient ratio.

Mistrust, discrimination and poor experiences further exacerbate unequal access to care

Disparities in access to care do not simply represent individual choices; they are structural and, in some cases, embedded in long-term mistrust and experiences of discrimination and exclusion. This is particularly the case for marginalised groups such as ethnic minorities, refugees and asylum seekers, and Gypsy, Roma and Traveller communities. 

Long-term mistrust compounds other barriers (e.g. poverty, immigration status, geographic isolation) and can lead to the avoidance of healthcare services, including vaccine hesitancy, which in turn contributes to the unequal distribution of disease. Systemic discrimination can lead to severe differences in healthcare experiences and outcomes (e.g. the maternity experiences of Black women). It can also lead to disparities in the rates at which some conditions are diagnosed (e.g. endometriosis for Black women).

There are disparities in cancer waiting times

Those living in the most deprived areas tend to face longer waiting times to start cancer treatment. For example, the 5 ICBs (Integrated Care Boards) with the least deprived populations generally have lower proportions of patients meeting the target timescales of receiving cancer treatment after an urgent referral has been made. Moreover, research indicates that Black and Asian patients experience longer waits for a diagnosis of some types of cancer.

There are inequalities in waits for elective care

There are currently a high number of patients on the NHS waiting list for planned hospital treatment, which significantly affects their quality of life. As shown in the graphs below, the waiting list has larger proportions of women (57%) compared to men (43%), while those from the most deprived areas are overrepresented amongst those facing the longest waits. A range of factors contribute to these differences, including gynaecology being amongst the four elective care specialities with the largest waiting lists and those in the most deprived areas more commonly having multiple complex needs alongside barriers to attending appointments. It is positive to see initiatives designed to address some of these inequalities, for example the ‘Further Faster 20’ programme focused on areas of higher economic inactivity. 

Lengthy waits for treatment cause harm to both physical and mental health, however the impacts of long waits are not experienced equally, with research suggesting that wealth, disability, education, gender and ethnicity affect who is hardest hit by waiting a long time for treatment (e.g. due to disproportionate impacts on the ability to work).

Inequalities lead to differences in hospital admission rates

The number of hospital admissions are higher in the most deprived areas, with particular disparities in the number of admissions for emergency care. Similarly, high intensity A&E use is 3.5 times higher in the most deprived areas, while people who experience homelessness are 60 times more likely to visit A&E in a year compared with the general population.

The reasons for differences in hospital admissions are complex but are affected by inequalities in the prevalence of certain health conditions as well as the conditions in which we live and work. For example, over twice as many children and young people in deprived areas are admitted to hospital for asthma, a condition affected by poor air quality and damp housing. The most deprived areas also experience higher hospital admissions related to infectious diseases (91% higher), alcohol (42% higher), and obesity (300% higher). Some types of hospital admissions (e.g. those related to alcohol or obesity) vary by gender, while other population groups (e.g. people in prison) experience unique barriers to using the hospital services they need.

An overview of the main pressure points in the NHS, including analysis of backlogs, staffing shortages and hospital beds, can be found on the BMA’s pressures pages.

The NHS will continue to struggle unless action is taken to address the building blocks of health, particularly for the most disadvantaged groups

Only a small proportion of the population’s overall health is determined by healthcare services. The main drivers of health lie in the building blocks of health i.e. the interconnected factors that shape our lives, such as secure housing, stable employment, access to healthy food and the surroundings we live in. The impact of health and social care services is limited where these key building blocks of health are not in place or are distributed unequally. The scale of this inequity is demonstrated by the following examples of the lack of equal access to these key building blocks of health.

Economic status is inextricably linked with health 

There is an interrelated link between income and health. Many of the key building blocks of good physical and mental health are not affordable in the UK without a decent income and without these, health worsens. As health worsens, so does the ability to work and participate in society, creating a cycle of poverty which is increasingly impossible to break. Over 14 million people in the UK live in poverty, including almost a third of children (around 4.5 million), with the UK having higher child poverty rates than most comparable European countries. A large proportion of those in poverty live in households with at least one adult in work.

Adequate housing is far less accessible for some groups

Access to secure and adequate housing, like the other building blocks of health, is a human right. The affordability and standard of housing across England is not sufficient, particularly in areas of deprivation. Without a decent place to live, the ability to maintain a good standard of health is seriously impeded. For example, living in a damp home is linked with increased risk of chronic respiratory conditions and it is estimated that 21.5% of excess winter deaths are attributed to cold housing. In 2021 it was estimated that poor quality, overcrowded housing costs the NHS £1.4bn per year (£1.7bn in 2025/26 prices).

Certain groups are more likely than others to live in homes with damp and mould, including ethnic minorities, those on low incomes, and those with disabilities. Overcrowding also damages health, with particular consequences for infectious disease and mental health. In addition, it is estimated that over 382,000 people in England are homeless, including over 175,000 children.

Food is not affordable for many UK households

Far too many people in the UK are experiencing food insecurity and the cost-of-living crisis is not felt equally across households. Recent analysis suggests that after housing costs, the poorest fifth of UK households with children would need to spend 70% of their income on food to follow the government’s official guidance on a healthy diet, compared with only 12% of income for the richest fifth of households. Research also suggests that, among adolescents in the UK, the consumption of UPF (Ultra Processed Food) is highest amongst those from lower socioeconomic backgrounds, those of White ethnicity and younger adolescents.

Employment status is strongly impacted by health

People living in more deprived areas are far more likely to be affected by long-term sickness, impeding their ability to work. Among those aged 18-64, the rate of economic inactivity due to long-term sickness in the most deprived areas is over double that of the least deprived areas. As demonstrated in the preceding data, there are a number of factors stacked against those living in deprivation driving higher rates of long-term sickness, compounded by the barriers to accessing care to improve their health. The ability to engage in good-quality, secure work is crucial to maintain health, while not having a stable source of income only entrenches ill-health and deprivation.

Surroundings have a fundamental influence on health  

Access to clean air, safe green and blue spaces, healthy food, and places to exercise are far less available to some groups, hindering the ability to choose everyday health positive behaviours and seriously affecting mental and physical health. For example, access to outdoor space varies significantly by ethnicity and, as shown in the graph below, deprivation. There is evidence that access to outdoor space and neighbourhood-level green infrastructure is good for health and wellbeing in both direct (e.g. physical activity) and indirect (e.g. air quality) ways. In addition, there are more fast-food outlets per person in deprived areas, leaving less space for healthier options and creating an environment where it is more convenient to eat food that harms health.