Oral health inequalities are being created and exacerbated The impact of COVID-19 on oral health is likely to be more severely felt by those who were already more likely to have poorer health outcomes raising concerns about the creation and exacerbation of oral health inequalities in the UK … Further information on trends in inequalities in health outcomes by area and individual characteristics, and the social determinants of health can be found in Public Health Outcomes Framework: health equity report, focus on ethnicity. The health gap between rich and poor is growing in England, according to shocking figures compiled by the Department of Health.. Our project, commissioned by the Department. the and resources to create social value and reduce health inequalities in the long term. These health inequalities, differences in health between people or groups of people that may be considered unfair, reflect historic and present-day social inequalities in our population. Asylum seekers and refugees are also at increased risk of experiencing depression, PTSD and other anxiety disorders. The level of inequality or ‘gap’ is 7 years for life expectancy and 20 years for healthy life expectancy, from the most deprived tenth of areas (decile group 1), up to and including decile group 4, healthy life expectancy was lower than 65 years, in the 3 most deprived decile groups, significantly more babies born at term had a low birthweight than the England average (2.8%), in the most deprived decile group there was a significantly higher infant mortality rate than the England average, in the 4 least deprived decile groups there was a significantly lower infant mortality rate than the England average, by mapping the level of deprivation for local authorities using, the local authorities that fall within the most deprived quintile are concentrated in the north of England, the Midlands and London, the local authority districts in the least deprived quintile are concentrated in the south of England, male life expectancy was highest in the southern regions of England and lowest in the northern regions, the South East had the highest life expectancy (80.5 years) while the North East had the lowest life expectancy (77.9 years), there was a similar north-south divide in male healthy life expectancy with the lowest healthy life expectancies being in the north of England and the highest in the south, the highest healthy life expectancy was in the South East (66.0 years) and the lowest was in the North East (59.6 years), female life expectancy was highest in the southern regions of England and lowest in the northern regions, London had the highest life expectancy (84.1 years) while the North East had the lowest life expectancy (81.6 years), there was a similar north-south divide in female healthy life expectancy with the lowest healthy life expectancies being in the north of England and the highest in the south, the highest healthy life expectancy was in the South East (66.7 years) and the lowest was in the North East (60.1 years), in both males and females, circulatory (heart disease and stroke), cancer and respiratory causes of death are the top 3 contributors to the difference in life expectancy between the most and least deprived quintiles, circulatory disease deaths account for 24% of the difference in life expectancy in females and 27% in males between the most and least deprived quintiles, cancer deaths contribute to 24% of this gap in females and 22% in males, respiratory causes of death contribute 20% to the gap in females and 15% to the gap in males, digestive, external, mental and behavioural, deaths in those under 28 days, and deaths due to other causes also contribute to the gap in life expectancy, excess weight in adults (aged 16 or over), 2013 to 2015, physically inactive adults (aged 16 or over), 2015, eating fewer than 5 portions of fruits and vegetables a day (aged 16 and over), 2015, smoking prevalence in adults (aged 18 or over), 2015, for all 4 risk factors, the lowest prevalence was in the least deprived decile group and, with the exception of excess weight, the highest prevalence was in the most deprived, smoking prevalence was higher than the England average (16.9%) for the most deprived 40% of areas and lower than the England average in all other decile groups, the prevalence of eating less than the recommended intake of fruits and vegetables was higher than the England average (47.7%) and the prevalence of inactivity was higher than the England average (28.7%) in the most deprived 30% of areas, and similar or lower for all other decile groups, the prevalence of excess weight by deprivation across all deciles was similar to the England average (64.8%), with no clear relationship to deprivation, however, the lowest prevalence was in the least deprived 10% of areas, eating fewer than 5 portions of fruits and vegetables a day (aged 16 or over), 2015, more men carried excess weight (68.4%) compared to women (61.1%), more women were inactive (32.2%) than men (25.0%), more men (52.7%) did not eat the recommended number of fruit and vegetables (5-a-day) than women (42.9%), more men were current smokers (19.1%) than women (14.9%), mixed ethnic groups had the highest prevalence of smoking, a lower prevalence of inactivity and excess weight, and a similar prevalence of eating less than recommended intake of fruits and vegetables, Asian ethnic groups had a higher prevalence of inactivity and of eating less than recommended intake of fruits and vegetables, but a lower prevalence of excess weight and smoking, Black ethnic groups had a higher prevalence of inactivity, excess weight and of eating less than recommended intake of fruits and vegetables, but a lower prevalence of smoking, White ethnic groups had a higher prevalence of smoking and excess weight, but a lower prevalence of inactivity and of consuming less than the recommended intake of fruits and vegetables, Chinese ethnic groups had a similar prevalence of inactivity and of eating less than recommended intake of fruits and vegetables, and a lower prevalence of excess weight and smoking, mortality rates under age 75 from heart disease and stroke were highest in the most deprived decile group of England and lowest in the least deprived decile group, in the 4 most deprived decile groups, mortality rates under age 75 from heart disease and stroke were higher than the England average, infant mortality rates were highest in people from the Pakistani group and lowest among people from the White Other group, for people from the Pakistani, Black African, Black Caribbean and ‘Not stated’ groups the infant mortality rate was higher than the England average, for people from the Pakistani group, infant mortality was twice as high as the England average, for people from the White Other and White British groups the infant mortality rate was lower than average, for people from Indian, Bangladeshi, and ‘All others’ groups, the infant mortality rate was similar to the average. But the term is also commonly used to refer to differences in the care that people receive and the opportunities that they have to lead healthy lives, both of which can contribute to their health status. Those in the most deprived areas are also more likely to suffer the harms associated with alcohol consumption, one of the risk factors associated with the highest proportion of deaths in the 15 to 49 age group [footnote 5], (chapter 2). Healthy life expectancy also varies between areas, reflecting both the level of deprivation and geographical location. As shown in the diagram above, the fundamental causes of health inequalities are an unequal distribution of income, power and wealth. Equality Act 2010 (2015). Figures 5 and 6 show healthy life expectancy at birth for males and females in 2015–17 by local authority area. Source: Public Health England. Inequality is far higher within London than in any other part of the UK, with London over-represented at both the bottom and the top of the income distribution nationally. As described in previous chapters, there are differences in health outcomes for men and women, for different age groups and for different countries. Both alcohol and drug dependence were found to be twice as likely in men as in women. For males, the area with the lowest healthy life expectancy was Blackpool, at 54.7 years, and the area with the highest was Rutland, at 69.8 years. The most common summary measure of these circumstances across a population is deprivation. This includes, but goes well beyond, the health and care system. They are strongly associated with socio-economic inequalities but can also result from discrimination. Differences in gender and racial community can also have an impact. 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