Health – specifically health inequality – is a hugely significant factor in social mobility. The nation’s health is far from a level playing field and, for some, health-related disadvantage begins even before birth. Recent research provides insight into the complex interrelationship of factors which influence health inequalities and highlights key areas, such as breastfeeding, where healthier practices would have a positive influence on health, wellbeing and, over time, social mobility.

Key findings

  • The poorest groups in society are least likely to take a proactive approach to seeking health services.
  • Despite government interventions, inequalities in health have not diminished; indeed in some cases the gap has widened over the past ten years which reflects widening inequality in wealth and income over this period.
  • When the NHS was founded, it was universally believed that making medical care free of charge at the point of use would inevitably reduce or eliminate health inequalities in the UK. Although overall health has improved dramatically, the health gap between the richest and poorest people has widened.
  • The poor enjoy less high quality health services, relative to their needs, than the richest and middle income groups. In other words, those in the greatest need receive the worst service. Policy should prioritise improving services for those with the poorest health outcomes.
  • Strategies to reduce inequalities in health outcomes have been largely ineffective because they treat the undoubted multi-dimensional contributors to health inequalities as though they act at the same level and fail to prioritise the need to reduce the fundamental drivers of social inequality,
  • In terms of policies to tackle inequalities, researchers find that breastfeeding is strongly correlated with better infant health, academic outcomes and socio-emotional problems and that in some cases this appears to be a causal relationship. Breastfeeding should be a measure for the Government mobility strategy as it is an effective and low-cost early intervention that can help address inequalities.
  • Work interruptions before birth are beneficial, especially if taken in the last three months of pregnancy. Stopping work earlier also appears to improve birth outcomes more for mothers with low educational qualifications.
  • Policies need to target very early age groups to be successful in implementing alcohol education programmes. These programmes need to involve parents to succeed in reducing the quantity and frequency of youth drinking.
  • There is a strong association between weight at birth and long-term adult outcomes, such as completed schooling, earnings and income.
  • A large body of research has already linked parental health-related behaviours such as smoking, alcohol consumption and body mass index to markers of child health. Research also shows that parental health itself is related to measures of early childhood health and development. As policies and interventions aimed at the individual level appear fairly limited in terms of long-run impacts on health and development, researchers suggest that policies aimed at tackling societal inequalities that shape the circumstances in which people live may prove more promising in the longer term for parental health and child health and development.

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