Analysis: ‘If the gap between rich and poor widens we can expect the problems to get worse’

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THERE is a well-observed relationship between inequality in health and inequality in wider society in most western countries.

The most deprived areas do not always have the best facilities, which is something that reproduces inequalities. That is a trend that we are seeing clearly in this report from Audit Scotland.

It is all linked to poor life expectancy among people living in deprived areas and of course that makes the problem worse.

A key question that now has to be asked of the Scottish Government is how do we improve access to services for those who have fallen behind as highlighted in the report.

In many ways the findings are not particularly surprising as social and economic inequalities in society tend to be mirrored in healthcare, as well as in other public services.

If the gap between the rich and poor widens then we can expect the problems in areas like the NHS to get worse for those at the bottom end. The findings also raise the question of what we can now do to engineer good health for people facing lower life expectancy and other health issues such as alcohol and smoking-related conditions.

We have to ask how we bridge the gap between the rich and poor. Some of the drivers of inequality in the NHS and society generally are things like alienation and people feeling they are not a part of something. Other things that have to be addressed as part of this is why people have bad diets and particular lifestyles that are damaging their health.

An important thing to remember is that inequalities in healthcare are not exclusive to Scotland. It is something that is replicated in other parts of the UK and that includes England.

There are well-documented studies about cities such as Sheffield where there is real social deprivation in services. Obviously, we are now starting to get bigger gaps in inequality and that includes the NHS. It is becoming a feature of our society and has been over the last 30 years or so. There has to be some sort of redistribution of resources if we are to really address problems like those highlighted in the report.

• Dr Chris Yuill is a health expert at Robert Gordon University.