Health Inequalities in the context of AHP practice
Health inequalities are systematic, avoidable and unfair differences between populations, within populations or across a socio-economic gradient. They occur because of the unequal conditions in which we are born, grow, live, work and age, including the social determinants of health such as income, wealth, education, welfare, housing and access to green space. Not only do these fundamental causes lead to disadvantage over the course of an individual’s life, they may also include an accumulation of historical events that determine the relative disadvantage of individuals, places and communities.
Health inequalities can be unpacked into inequalities in health care and inequalities in health outcomes. Health care inequalities includes differences in access, diagnostics, treatment, experience or health care funding and workforce and health outcomes inequalities refers to differences in morbidity and mortality. These differences may be seen across the socio-economic gradient; disadvantaged groups (e.g., ethnic minority groups, LGBTQ+); or inclusion health groups (e.g., homeless, undocumented migrants). Health care inequalities are under the control of health care organisations, but health outcome inequalities are primarily driven by wider factors, such as the social determinants of health.
People sometimes think that the concept of health inequalities relates only to people working at population level and not practitioners who focus mainly on the care of individuals. But there is growing recognition that this is not the case. It is something that affects every one of us whatever our role, and each of us can make a difference, by supporting the individual person you’re caring for better, and by seeing that that person is part of their community, and the population. Whatever change is made, at the individual, service, community or wider level will impact on population health by reducing inequalities.
With over 4 million client contacts every week, AHPs hold tremendous power to tackle health inequalities.
The global pandemic is exacerbating existing health inequalities. Members of disadvantaged communities are more likely to be infected with COVID-19 and to ultimately die of the virus. In addition, the indirect impact of the pandemic will be more severe on these communities, through its long-term impact on healthcare services, the economy and mental health.
The AHP community has played an important role in the efforts to face and overcome COVID-19. The challenge as we move forward is to consider our role in minimising health inequalities within our communities. From small steps to big efforts, every person’s contributions will count, and together we know that we can make a difference to improving population health.
To support AHPs to maximise our contribution Public Health England, NHS England and Improvement and the 14 Allied Health Professional Bodies have worked with The King’s Fund to develop a framework to help any AHP consider their role in tackling health inequalities. This framework has been created with insights from over 1000 AHPs to help AHPs to find their own unique role in this and to explore ways to maximise their contribution:
Whatever your role, seniority, specialism or interest, the framework supports you to consider your role through 6 lenses:
• you as an individual,
• your role in caring for individuals,
• being a part of a team and service,
• your involvement with communities and networks,
• your involvement in the wider health and care system,
• and your efforts to nurture the future.
For each of these six aspects the framework encourages a focus on what AHPs need to know, the actions to take and their role as an advocate.
I hope AHPs will find this framework and the associated case studies helpful in guiding efforts to improve population health and reduce health inequalities.
‘My role in tackling health inequalities: A framework for allied health professionals
’ can be accessed here
Linda Hindle, Deputy Chief AHP Officer for England
PHE Lead Allied Health Professional and National Engagement Lead for Public health in Police, Fire and Ambulance Services