Health Inequalities in the UK: Why Where You Live Can Affect Your Health

Why Where You Live Can Shape How Long You Live

We often talk about health as though it is mainly the result of individual choices. Eat well, exercise, stop smoking, drink less alcohol and get enough sleep. These things certainly matter, but they are only part of the picture. Our health is also shaped by the circumstances in which we are born, grow, live, work and age, including our income, housing, education, employment, relationships, neighbourhood and access to healthcare. These differences are known as health inequalities. NHS England describes them as unfair and avoidable differences in health between different groups in society. They can be seen in how long people live, the conditions they develop, the quality of health they experience and their access to services. 

The scale of these inequalities is considerable. According to the Office for National Statistics, in England in 2022–2024, life expectancy for men living in the most deprived areas was 73.2 years, compared with 83.6 years in the least deprived areas. For women, the figures were 78.3 and 86.4 years respectively. The difference becomes even more striking when we look at healthy life expectancy. Men in the most deprived areas could expect around 49.8 years of good health, compared with 69.2 years in the least deprived areas. For women, the equivalent figures were 48.2 and 68.5 years. In other words, the gap in healthy life expectancy is close to 20 years. 
This matters because health inequality is not simply about dying younger. It can also mean living for much longer with illness, disability or poor health. The reasons are complex. Someone living on a low income may be more likely to experience insecure work, financial stress or poorer housing. They may have less access to green space, fewer opportunities for exercise, more difficulty affording healthy food, or practical barriers to attending healthcare appointments. These factors often overlap and reinforce one another, which is why health cannot be fully understood by looking at individual behaviour alone. 

This is also why the idea that people simply need to “make better choices” can be misleading. Choices are always made within circumstances. Knowing that exercise is beneficial does not necessarily mean someone has the time, money, safety, confidence or local facilities to exercise regularly. Knowing that a healthier diet is important does not automatically make nutritious food affordable or easily available. Health behaviour is shaped by opportunity as well as motivation.
Health inequalities are not only related to deprivation. Ethnicity, disability, geography and social exclusion can also influence people’s health experiences and outcomes. Maternal health is one important example. The latest MBRRACE-UK analysis found that Black women remained more than twice as likely to die during pregnancy or in the year after pregnancy as White women. Women living in the most deprived areas were also at substantially greater risk.  These differences do not mean that ethnicity itself causes poorer health. Instead, they raise important questions about access to care, quality of treatment, socioeconomic conditions, discrimination and whether healthcare systems respond equally effectively to everyone.

Reducing health inequalities therefore requires more than encouraging individuals to change their behaviour. It also requires services to identify where the greatest inequalities exist and to respond to the barriers people face. NHS England’s Core20PLUS5 approach focuses particularly on the most deprived 20% of the population, alongside groups experiencing poorer access, experiences or outcomes. 

For anyone considering a future in health and care, this wider perspective is important. Good healthcare is not only about understanding illness and treatment. It is also about understanding people, communities and the circumstances that shape health. Looking beyond the individual allows us to ask better questions: not only “What choices is this person making?” but also “What pressures are they facing, what resources do they have, and what barriers might be getting in the way?”

At CASS, issues such as health inequalities, barriers to health, health behaviour and health promotion form part of the wider learning explored through our Level 2 Certificate in Essential Skills for Further Study in Health Science Professions. For learners thinking about progressing towards healthcare study, understanding why health differs across society is an important place to begin.

Sources and further reading

NHS England. What are healthcare inequalities?
A useful overview of health inequalities, wider determinants of health and barriers to accessing healthcare. Read on NHS England

Office for National Statistics (2026). Healthy life expectancy by national area deprivation, England and Wales: between 2013 to 2015 and 2022 to 2024.
Published 15 April 2026. Source for the life expectancy and healthy life expectancy figures used above. Read the ONS report

MBRRACE-UK / National Perinatal Epidemiology Unit, University of Oxford (2025). Continuing inequalities in maternal mortality.
Provides the maternal mortality figures by ethnicity and deprivation discussed in this article. Read the MBRRACE-UK summary

NHS England. Core20PLUS5 (adults): an approach to reducing healthcare inequalities.
Explains the NHS framework for targeting healthcare inequalities among the most deprived populations and other groups experiencing poorer outcomes. Read about Core20PLUS5