Health inequalities are defined as differences in health status or in the distribution of health determinants between different population groups. For example, differences in mobility between older people and younger populations or differences in mortality rates between people from different social classes. Health inequalities can be attributed to biological variations, free choice, the external environment e.g. education, housing, transport, poverty, and other conditions mainly outside the control of the individuals concerned. 

There are important reasons in Bradford District and Craven why we need to take collective action now. 

Firstly, the variation in healthy life expectancy between different communities and between different groups of people. Healthy life expectancy is the average number of years a person is expected to live in good health. Women living in parts of central Bradford can expect 49 years of healthy life expectancy compared to 72 years in Wharfedale (a 23-year difference). The gap for men is between 51 and 71 years (a year difference). These inequalities also occur for specific groups of people. For example, those with a severe learning disability have over 25 years less life expectancy than the general population.

Secondly, we need to respond to social and health inequalities that were exposed by the COVID-19 pandemic. During the pandemic, we saw a higher death rate from COVID-19 for those with long term health conditions and disabilities, with careering duties, those on low incomes, minority ethnic communities and in some key worker groups.

Thirdly, tackling inequalities requires us to address structural failures in society. We want to ensure that equity, diversity and belonging is a core focus in our programmes. Integral to reducing inequalities is a new approach to inclusive leadership across our services and partnerships to facilitate cultural change.

Finally, although the social and moral imperative to reduce inequalities are clear, there is also a strong financial argument. Health inequalities are estimated to cost the NHS an extra £4.8 billion a year, and society around £31 billion in lost productivity, reduced taxes, higher welfare benefits and responding to social issues. 

A useful way of looking at inequalities is the ways in which they reveal themselves. These are differences in health between those with protected characteristics or groups that are marginalised in society (inclusion health groups); differences in socio-economic status (e.g. by wealth, employment and housing status); and differences between different geographical areas – four domains of inequality.

The domains of inequality describe inequalities between groups but we are all individuals. Another way to look at inequalities is to consider ‘Intersectionality’. This describes the reality of people’s lives who may face multiple disadvantages. The wheel of power and privilege demonstrates this complexity.

The Inequalities Call to Action for Bradford District and Craven describes the types of inequalities that exist locally and how you can get involved to be part of the solution.

https://issuu.com/reducinginequalities/docs/reducing-inequalities-alliance-report-v5.7?fr=sZTQ3NTY3Njg3NTM

To address Inequalities in Bradford District and Craven we need action on many fronts across. We need to take a data and intelligence led approach to understand where inequalities exist, where the greatest needs are, and how our services and community assets can be part of the solution. We want to create a culture where addressing inequalities is everybody's business.

Therefore within the Bradford District JSNA, rather than having a single inequalities page, we will aim to make inequalities a golden thread through all JSNA sections. 

Action to tackle inequalities is shared between partners in Bradford District and Craven including:

• A Reducing Inequalities Alliance https://bdcpartnership.co.uk/strategic-initiatives/ria/ that aims to support and coordinate action to reduce inequalities. 

• A Living Well programme aiming to create a district where it’s easier to adopt healthier lifestyle behaviours. https://mylivingwell.co.uk/

• Research and Innovation to reduce inequalities via our academic institutions including the Born In Bradford (with a focus on childhood and families), Act Early (https://actearly.org.uk/our-projects/publications/) and a Health Determinants Research Collaborative with a focus on the wider determinants of health.

• An Equality, Diversity and Belonging (Diversity Exchange) to create a fairer place to live, learn and work, based on strong foundations of trust and fairness. Where everyone feels they belong and are treated equitably and can reach their full potential. Get involved - Bradford For Everyone

Work to reduce inequalities is also happening within a broad VCS sector locally and their representative organisations (VCS alliance & CABAD), and within the partnerships that sit under the local Well-being Board and Health and Care Partnership.