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The chances of being admitted to hospital with infectious diseases are dramatically higher in people of certain ethnicities, from particular geographic areas and those living in deprivation, according to the first study of its kind by the UK Health Security Agency.
The agency said inequalities in health protection “have a high human cost” and “a wider societal impact, including on health services and economic productivity”.
Among other striking statistics, the report found that emergency hospital admission rates for tuberculosis were 29 times higher for a group described as “Asian other” compared with White British people, 27 times higher for Indian people and 15 times higher for Black African people.
People living in the 20 per cent most deprived areas in England are almost twice as likely to be admitted to hospital due to infectious diseases than the least deprived. Those living in the North West are 30 per cent more likely to be hospitalised for an infectious disease compared with the English average.
The report, published on Friday, found that people living in areas of high deprivation typically had “higher levels of air pollution than less deprived and less ethnically diverse areas” and were more exposed to adverse weather “including thermally inefficient housing, fuel poverty, a lack of air conditioning and distance from cooling environmental greenery”.
Dr Leonora Weil, UKHSA deputy director for health equity and inclusion, told a symposium at the Health Foundation, a research organisation, that health inequalities “are avoidable, persistent, pervasive and preventable”.
By making the data “visible” the aim was that the UKHSA, working across national and local government, the NHS and voluntary sectors, “can . . . make those changes to allow communities to live longer and in better health”, she said.
The UKHSA estimated that, as well as the costs to the social, physical and mental health of communities, “inequalities in emergency infectious disease hospital admissions cost the NHS between £970mn and £1.5bn in 2022-23”. Infectious diseases were the primary reason for more than 20 per cent of hospital bed usage in England, at an annual cost of almost £6bn in 2023-24, the agency recently suggested.
The report shows that in deprived communities emergency hospital admission rates are twice as high for respiratory diseases in general compared with the least deprived communities, up to seven times higher for TB and six times higher for measles.
Highlighting one way in which use of data is making a difference, Weil cited significant measles outbreaks in 2023, particularly in London and in Birmingham.
“We have real-time data flowing on MMR vaccination from GP records” and have been able to see “very precisely what we have in terms of ethnicity, deprivation status, where people live”, she added.
That had also “allowed us to look at the very targeted campaigns that we’ve done and to see . . . which parts of the campaign have had an impact”. The ethnicity data had enabled the agency, working with its health protection teams, to target approaches and “look at who has been or who hasn’t been vaccinated, to work most effectively with them”, she said.
The UKHSA’s report concluded that more analysis was required “to understand the multiple contributing factors to these inequalities and the interaction between demographic characteristics”. The causes and solutions were often “systemic, structural and complex”, it warned.
The Department of Health and Social Care said: “This shocking report shows the appalling healthcare inequalities this government inherited. Our Plan for Change is reforming the NHS to get it back on its feet so it is there for everyone, regardless of who they are or where they live.”
It added that the government had delivered an extra 3mn appointments since July to cut waiting lists and was “taking radical action to shift the focus of care from sickness to prevention so that people live healthier lives for longer, regardless of their background”.
