What measures could the government take to improve health in poorer areas? Health inequalities are growing between the rich and the poor, independent experts say.
The government had pledged to reduce the gap, measured by infant mortality and life expectancy, by 10% between 1997 and 2010.
But this latest research by the Scientific Reference Group of Health Inequalities has shown that the difference has actually increased between the poorest and population as a whole.
What can be done to improve health in the UK? Should the government play a role in encouraging people to be healthier? Would you welcome a health trainer? Send us your comments.
This page is now closed. Read a selection of your comments below.
The following comments reflect the balance of opinion we have received so far:
 |  It's not the government's job to improve our health or reduce inequalities |
It's not the government's job to improve our health or reduce inequalities. This is a matter of individual lifestyle choices. Besides, there are lots of ways to be healthy and save money. Just walk more, smoke less, drink less and cut out over-priced processed foods.
Tim Parkin, London UK Stop making excuses for people by saying healthy food is not available to them. It is they are just lazy. To exercise they do not need to go to a gym, they can walk to the supermarket. The fact that it is a long way only makes the benefit greater. To use the excuse that smoking and drinking are used to escape from poverty is pathetic and hardly worth commenting on.
Jim, York, UK
It's not a question of a gap between poor and rich, it's about how you value your life as a whole. If you are aware of the value of your life you will do whatever it takes to keep yourself healthy.
Lulu, Tanzania, Dar Es Salaam
I can't believe all this stuff about expensive gyms. I've never been to a gym in my life but I walk to and from work every day, about three miles. It costs me nothing, actually saves money on transport and makes me feel great. As for sitting in a tower block not knowing how to do simple exercise, how about going down to the ground floor and walking back up the stairs? Job done.
Val, Loughborough, UK
The thing that most people don't seem to realise at all is that although poverty is not the cause of health inequalities, however health inequalities are quite often the cause of poverty, I personally have MS and cannot work at the moment, this may have something to do with the figures, that those with a low household income die earlier is no surprise to me as I know many who are on benefits because of disability. I cannot take a huge amount of exercise due to my condition, this is likely to shorten my life span.
Ceri Jones, Cambridge, UK
Everybody has a life style choice. Whilst income does restrict choice it so happens that many of those on lowest income levels have the highest consumption levels of tobacco and alcohol. Whilst it costs to join a gym it costs nothing to go out for a jog.
Peter Smith, Walton On Thames
So when I return home in winter to the 8th floor of the tower block where we live, I'm supposed to take the kids out for a walk or send them out to play. Whereabouts should we do this? - the local park? full of dog excrement and used syringes? Oh yes and I'd be better of going to 'pick your own' farm shops! Where exactly? Without a car and no public transport links. As for joining a gym... where? and where does the money come from? I'm on minimum wage and my children need new shoes - but hey kids the Know-it-alls think mummy should be down the gym instead. I don't smoke and don't drink - but I work 9am - 6pm Mon to Sat - can anyone tell me where these local friendly butchers and grocers are who are open outside this time!? I'd gladly 'get off my butt and walk a mile' to get there but there's no point if they're all shut!
J, Cardiff UK
| Try healthy diet options for a family spanning 80 years and you're spending nearly �250 a week |
This is, for many, a price question. People are so used to supermarket choices, they forget many people do not have supermarkets within easy access. They also ignore the fact that people are often catering for different needs and medical conditions - try healthy diet options for a family spanning 80 years and you're spending nearly �250 a week! And gym fanatics - try carrying a load of 25 kilos (roughly 50lbs) weight up 200 feet in less than a quarter of a mile four times a week. My knees are knackered, but I can't have the necessary operation because there's no care for the rest of my family. I do wish you'd stop being so smug and insulting to people who are really trying; who aren't unintelligent but are simply strapped for cash on low incomes and try to do their best.
JR, Scotland I have been working as a dentist for two years. The biggest problem is the lack of focus on prevention! Plenty of governments have changed the structure of the NHS, very few have changed the delivery of care. Most of the UK's water supply is not fluoridated resulting in high caries rates especially in deprived areas. Furthermore there are huge recruitment problems in these areas. Rather than focusing on highly technical treatments we need to strengthen preventative strategies and funding research programmes dealing with prevention.
G Sudle, Bradford
What can be done to improve health in the UK? Perhaps training and retaining more NHS doctors and dentists would help. The poorest simply can't afford to "go private" if their NHS dentist decides to leave the public sector.
Andy G, Teesside, UK
Recent research by British scientists found that children who are fed a wider range of foods before the age of two are less likely to become picky-eaters. It's all about recognition. It's a bit late for this generation, but if people start giving their babies real fruits and veg, blended without any additives, instead of buying them processed crap, then the next generation may be in better nutritional health. It doesn't cost any more to feed a baby the same food as you eat, just make sure you prepare it correctly.
DW, UK
The benefits of a good diet need no further advertising. We are inundated with diet news constantly. People know what good eating is all about and the benefits of proper rest and exercise. They just don't do it. And even worse, they teach their children the same bad eating habits, filling them with sugar, salt, and trans-fats continually - unable and unwilling to say no to the little dears. We sit them in front of the TV with a Coke and a packet of crisps to keep them quiet and occupied. And then those children grow up to pass on to theirs what they have learned. I never thought I would say this, but I am ready to accept a society in which we are held responsible for our health and that of our children, by denying health and other benefits to those who refuse to take a minimal of responsibility for their own health. The overall costs of healthcare and other health-related benefits is spiralling out of control - due mainly, in my opinion, to parents such as these.
Victor, Oxford, UK
We can only begin to tackle health inequalities if we truly understand the nature of what we are dealing with. There are a plethora of factors involved in creating these inequalities. You cannot eat healthily if you live in a food desert where no shops sell fruit and vegetables. They may be cheap, but if you have no direct means of accessing them then you will eat what is on offer, which is usually cheaper processed foods. Also, smoking and other lifestyle choices may not be choices at all if they are the only escapes from a life of poverty. Many people of poorer health are not downright idle and lazy but live in an environment that does not afford them the luxuries of a healthy lifestyle, such as eating organic vegetables and going to the gym every night! The complexities of living a healthy life sadly do not allow for an easy solution.
Joseph Milton, Dunfermline, Fife, Scotland Health, fitness and longevity are primarily middle-class priorities and preoccupations. Poorer people have other priorities which conflict with these goals, such as smoking, driving modified cars, and watching televised sports. It's time that the government tackled this classist bias, and started promoting these lifestyle choices in equal measure, instead of wasting our money on this paternalistic and patronising nannying.
Michael Calwell, Edinburgh
We need to start educating pregnant woman about healthy eating for both themselves and their child. We should offer cookery lessons as part of ante-natal care and these should be repeated once the child is being weaned. As a mother I am shocked to see how many babies only ever get fed processed baby food. We need to get children interested in good food from birth.
Irina Reid, Scotland
Why does everyone keep saying it costs money to eat healthily - it's actually cheaper? For the cost of one fast food meal I could feed a family cheaply and healthily for a day. An apple costs less than a bar of chocolate, an orange costs less than a packet of crisps. Unhealthy convenience food is expensive.
Matt Munro, Bristol, UK
Carrots and cabbage are cheap. Healthy brown rice is extremely cheap. Many large supermarkets do cheap fruit if you buy what is on offer. There are many sources of vegetable protein which are a faction of the price of meat. Anyone who thinks it is expensive to eat a healthy diet is looking in the wrong shops. You only need to look in the average shopping basket and see the fizzy drink, the red meat, the cakes and the ready meals to know that most people don't even try.
Roger, London
It is not expensive to eat healthily but people do need to have the time, skills, decent cooking facilities and emotional "space" to do it. Part of poverty is people being brought up knowing very little about how to cook healthily. It is also that the very poorest people are often desperately overworked doing several low-paid part time jobs. This means women, by and large. The worst mental and physical health inequalities happen in countries where there are the widest gaps in wealth. This is quite well researched.
Diana Proudfoot, Derby
I note some of the more ignorant among you claim that fresh fruit, veg and meat are more expensive than the rubbish you buy in your supermarket. We took the decision over a year ago to buy foodstuff solely from the grocer or butcher. Result is that our weekly food bill is less than half of what it was and our health is better. What most people need is education on how to cook with raw materials. I know too many people who cannot even recognise vegetables/cuts of meat, let alone cook them.
Kitty H, Chesham, UK
| It's about personal choice, not affordability and blame |
I earn the minimum wage, and I'm far from rich. However, I cook all my own food, can make chicken and vegetables last all week (very cheap and healthy) and I run and walk outdoors - so don't need for an expensive gym. It's about personal choice, not affordability and blame.
Alvin, Cambridge This is more complex than the cost of fruit and veg. Of course there is an element of individual but we are also feeling the impact of the insane planning policies of yesteryear eg building housing estates the size of small towns on the outskirts of cities with no access to shops and poor transport etc. Current policies aren't helping either - continuing the sale of school playing fields, diabolical catering in schools and cheap and easily accessible alcohol.
Sarah, Scotland, UK
We cannot tackle the gap and we should not even try, people have access to TV, books, newspapers and magazines, even the most trashy mags have diet features these days. You don't need access to a gym to get exercise - what's wrong with walking? People just need to take responsibility for their own lives and health
J, Chelmsford, Essex
A large part of the problem is the price of food. Healthy fresh fruit and veg are often prohibitively for the poorer section of society. Making chips, beans and synthesised chicken nuggets the only feasible budget meal. A system of food subsidies and taxes could eliminate this discrepancy.
Angus Wood, Edinburgh
| The high cost of gyms is just another excuse for not exercising |
A note to all these people who think you need to go to a gym to get fit. What's wrong with jogging or power walking? After the initial outlay for a pair of trainers (which most people own anyway) it costs nothing. The high cost of gyms is just another excuse for not exercising.
Anne, Bristol People here are saying fresh fruit and vegetables are expensive. Well, that's as may be. But it's a lot cheaper than the cigarettes these people are well able to afford. If they even cut down on smoking they could easily afford a better diet, and if they stopped altogether they could probably get a gym membership too.
John, London, UK
That there can be such a gap in health is surprising to me as an American who has spent his life lobbying for universal healthcare in the US. The difference, I think, is that in the US the poor have no healthcare and it's getting drastically worse, so at least the UK is trying and I commend (and envy) it for that.
Michael J Kelly, Boston, MA USA
I would love to join a gym, but I just can't afford to. There are no public leisure facilities within five miles of my home, and no effective public transport to take me to a sports centre further away. No wonder there are so many unhealthy people around here.
Michelle, Leicester, UK
Education alone is not the most effective way of achieving better health. An individual's ability to change depends on their social and material environment. Different groups within our society have different norms. This can make it easier for some groups than others to follow health advice.
Tanya Knox, Bradford, West Yorkshire
The country with the world's lowest rate of obesity is India. A rich nation with supermarkets on every street corner, affordable health clubs for all and government handouts a plenty - no. A country of resourceful, active people with a deep appreciation of food - yes.
S Smith, Buckingham, UK
| These people must be educated about health and lifestyle, not given money or more benefits |
These people must be educated about health and lifestyle, not given money or more benefits. A shopping basket full of fresh vegetables is very cheap and it costs nothing to walk to the shops to get it - the exercise would benefit both body and mind.
Matthew, Yarm, Cleveland Early to bed and early to rise makes a man healthy, wealthy and wise. Lying on a couch all day eating chips watching soap operas makes a man fat, poor and very unlikely to read this comment.
Justin Wall, London
To all those who have written 'this is all about lifestyle choice'; the figures released today are partly about infant mortality. Newborn babies don't get to choose their environment or the lifestyles of their parents. That's why these things matter.
Richey, Scotland
Unsurprisingly, the areas most affected by ill health are those areas where slothful and gluttonous lifestyles are most prevalent. More self respect, respect for others and getting up from their lazy backsides to both get a job and do some more exercise would be far better than wasting hard working taxpayers money.
Dr W Simon, London
| I don't think the issue is wealth, I think the issue is education |
I don't think the issue is wealth, I think the issue is education. You can give people money until you are blue in the face but if they are not going to spend that money on healthier food and better living then what is the point. In contrast if people are educated in the benefits of healthier eating then this would pay for itself in reduced NHS costs. I think that the issue of sport and meals in schools should also be addressed as these are large contributors.
Ed Gibbs, Oxford, UK This problem is not going to go away overnight. It is a mixture of society, culture and lack of knowledge or education about living a healthy life. My local area is one of high deprivation but trying to get the general public to understand that much of it is in their own hands to change is a huge hurdle to overcome. Plus the government won't see the effects of all the health schemes until 10 or 15 years time, lifestyle change is a huge process!
Cassie, South Shields, Tyne & Wear
No one in the UK is too poor to live healthily if they choose - the key killers are ones of excess (smoking, alcohol, sloth) not deprivation. However, income and education are closely correlated and the better off are better informed and thus more likely to live healthily, and have a peer group that is similarly inclined. In preventative medicine, education is therefore the key. Of course, in curative medicine more investment may be needed if lower income areas are indeed deprived of health care to the best standards.
David Edwards, Dubai
As a social epidemiologist and geographer it is interesting to note that the most ill-informed of those who have commented so far have been Doctors! Assuming that they are clinicians it seems amazing to me that those who may actually deliver healthcare at the frontline still believe that poverty doesn't matter and that no-one has an equal right to health. Social conditions are inextricably linked to health and decades of research have shown that poverty is associated with the major risk factors for health. If they don't see this in their everyday work then I wonder if they are really looking.
Dr Steven Cummins, London, UK
Interesting that the most sensible comments have been made by doctors! Something no-one has brought up is the nature of statistics regarding 'inequality gaps'. If I start on 5 and you start on 10 and both of us gain 20% the gap between us widens from 5 to 6, but we are both better off than we were.
Rob Fletcher, London, UK
| Bring back domestic science to the curriculum and make it compulsory for both sexes |
Education is the key to public health. Bring back domestic science to the curriculum and make it compulsory for both sexes. We now have two generations of families who are unable to cook and rely on unhealthy fast food and ready meals. Pre and anti natal classes should include in depth information on nutrition, highlighting the effects in later life of feeding children a bad diet.
Lyndon Gee, London Unfortunately, fresh fruit and vegetables cost rather more than frozen and packet food. Also gym facilities and decent recreation areas are much less available to those living in poorer areas. It seems to me that quality of life is still explicitly linked with personal income. The government needs to address these issues. It is too easy to assume that bad health is a choice
Jamie, Leicester
Healthy food is much more expensive than non-healthy food. Just look at the prices of fruits and vegetables, or real fruit juices without lots of added sugar.....
Veronique, Cardiff
Substitute 'poor' with lazy and you might be nearer the mark. Many people are just downright idle and lazy and will always choose the easy option no matter what. With a mile walk each way and fresh fruit and veg to eat what health problems would they then have - none, and of course you then have to cook the nasty fresh stuff rather than bung it in the microwave - oh and what about the washing up afterwards when you can just throw the foil tray in the bin - no recycling there of course either! As a lone working parent for many years I dished up wholesome, nutritious, cooked-from-fresh food for me and my son every night.
Ann Thwaite, UK
If healthy food, such as fruit & veg was subsided like meat and other animal products are, we would be more able to afford a healthier lifestyle. If the government taxed junk food and reduced the cost of organic food, we would all benefit. Also, if more people walked or cycled rather than relying on their cars there would be less pollution and we would fitter as a result.
Rebecca, Coventry
I believe that there is a link between poverty and health. People who can afford to will shop for food from quality suppliers/retailers. Those who cannot afford as much have to rely on 'own brand' products or shop in budget supermarkets. Wealth also has a factor on whether you lead an active lifestyle, i.e. able to afford to go to a gym - even local authority-run gyms charge an admission price.
Barry Ray, Rainham, Essex, EnglandI feel myself wasting away in my room within a concrete tower block, nothing to do all day everyday. I would like to do some simple effective exercise. Why is there not even a government website that includes diagrams for basic exercise equivalent to the books/pamphlets of Dr Adrien Proust promoted to the French in late 19th century? 10 minutes of simple effective exercise would be 100% better than none at all.
David O'Malley, Hackney, London
Commercial TV offers escapism to a large number of people through trashy programmes, fast food convenience, and quick-fix indulgences. Glossy magazines indulge the vanity of the better off who perhaps feel they deserve their svelte, organically-grown, personally-coached bodies (because they're 'worth it'?). In many respects, the health-poor seem quite resigned to their vices (and the eventual impact/loss to quality of life), while health-rich are often fanatic about clinging on to their wealth.
David Booth, Leicester
Having read recently in the news about millions of people in Niger starving to death it seems ludicrous to dedicate so much media space to those in Britain who are smoking and eating themselves into a (slightly) earlier grave.
James Adams, Ealing, London
Richard Hobbs makes an important point, perhaps more research is needed into why the better off adopt healthier lifestyle choices. Once we understand the motivation for their changes in behaviour it may be possible to use findings to increase the motivation of those less well off to adopt similar changes.
Ted Yeoman, Stamford, UK
Having worked in social housing for a few years I believe that increasing benefits and giving more money to people who have no interest in staying healthy will not change their style of living. Instead it will perhaps give them a chance to spend more money on alcohol and junk food. I believe that education and sport activities would make a difference to those who spend a lot of time in front of television and have no desire in doing anything else.
K Burrows, Norwich, Norfolk While part of this outcome, as noted, is due to personal factors, other factors are environmental. In this group, the government - as seen so often - has failed to take the lead, especially where it involves the perception of the middle classes "losing out." This kind of result you'd expect under a Tory government - but under a Labour one, this isn't acceptable. No wonder people are so turned off by politics and politicians.
Dave Critchley, Bolton
Simple. Stop smoking. Much greater emphasis is needed in schools to show the evils of tobacco. I think that tobacco companies should have to pay a special health tax to pay for treating the illness they cause. I don't remember seeing a tobacco company representative on the cancer ward.
Ed, Shrewsbury, England
Part of the problem is that you can provide lots of health improvement/education initiatives, but you cannot make people live healthier lives. Few people can honestly claim not to be aware of the health risks associated with junk food or smoking, yet they still choose to ignore the dangers. It is not a wealth issue - healthy food is actually quite cheap, and cigarettes are extortionately expensive - but one of society where it is the norm to smoke a fag while tucking into your fish and chips.
Alison, Leeds, UK
There is a huge misconception that healthy eating is expensive. It is not. The cost of basic vegetables and dried pulses is a lot less than the processed muck that a huge number of people buy. If you buy what fruit and vegetables are in season or go to 'pick your own' places it is much cheaper as well. What is needed is education on how to cook properly with cheap basic foods and encouragement for families to go for walks and kick/throw a ball around instead of slumping in front of a TV or game station.
Karen, Southampton, England Isn't it stunning that obesity and idleness are now associated with poverty and not wealth? When we have come so far, it is really worth fretting about the health inequalities that result from people's own lifestyle choices?
Rob Findlay, Shrewsbury, UK
These studies incorrectly assume that health should be "equal". However, the moment one person decides to give up cigarettes and take up exercise then they become "unequal" to those who keep smoking and sit at home. We are also "unequal" because some read books and some don't, because some are cautious and others take risks, and because some follow advice and others don't. We should accept that people are different. Despite that, we have all got much healthier over the last century.
Dr James Thompson, London
It is clear the government is loathe to increase the basis rate of taxation for those that are better off. If it had the courage to seize this opportunity and target the additional income in those areas that poverty is most prevalent this would undoubtedly make a real difference. Instead, it chooses to play around the fringes with tax credits, new food and other initiatives launched every month, that are political tools that make minimal difference.
Gordon Liddle, Edinburgh, Lothian
Investment into leisure facilities which are accessible to all, linked with changes to peoples lifestyle and cultural attitudes. Poor health is not necessarily linked to low income. Personal wealth is not needed to kick a ball or go for a walk.
Susan Guest, Loggerheads Shropshire
| The problems are not due to lack of money but are social in origin |
It is a widespread misconception that poverty is the cause of health inequalities in the UK. This may be the cause in Africa but it is not here. The causes are smoking, over consumption of fatty foods, sedentary lifestyle and alcohol. These are all problems of excess i.e. misdirected personal funds. As such, the problems are not due to lack of money but are social in origin. Hence the solution is not to throw money at people but to educate, empower and encourage healthy choices. I don't think the government's schemes have that in mind.
Dr Reed, ReadingI agree with Dr Reed that poverty is not a direct cause of health inequalities. However, I think that people who live in poverty stricken areas do have lower self-esteem than others, and perhaps do not see the point in living a healthy life. Resources should be targeted at young people to try to convince them that there is more to life than eating rubbish and watching TV.
Kevin, Glasgow, Scotland
Dr Reed is correct in saying that health poverty is linked to social origin but incorrect in saying that government schemes are ignoring this. Open any copy of the British Medical Journal or Public Health News and it will be filled with case studies of schemes in poorer communities with the direct aim of educating, empowering and encouraging healthy choices. However in the end it is down to the individual to take responsibility for themselves, there is only so much anybody can do.
Ms B, Oxford
In my opinion diet is a huge factor. People from poorer backgrounds watch more TV. If children and their parents are bombarded with advertisements for the wrong foods, then how are they meant to make an informed decision about their diet? I myself have started to follow a healthy diet over the last few years and it is very expensive, if you are poor you have to settle for inferior foods that in turn cause ill health. It's a disgrace; we need more Jamie Olivers on the case!
David, Bournemouth
Start by banning smoking in all public areas T-bone steaks were banned quickly enough over a small risk of BSE a few years ago. Subsidise items such as fruit and vegetables from a levy on processed foods and take aways. Provide affordable leisure facilities and swimming pools, Fenland District Council do an excellent job in our area.
Bill Tate, Whittlesey, UK
It seems to me that the better off will always be able and willing to improve their own health more than those in deprived areas, just by their own efforts. Certainly resources should be targeted at those in poorer and more deprived areas, but perhaps we should focus more on improving everyone's health, rather than looking at the gap. If the life expectancy of the better off actually fell, that would reduce inequalities, but clearly that wouldn't be in anyone's interest.
Richard Hobbs, Nottingham UK
One-Minute World News 
News services
E-mail this to a friend 
Printable version 
