The Inequalities in Health Alliance (IHA) is a coalition of more than 250 organisations, convened by the RCP, which campaigns for a cross-government strategy to reduce health inequalities. This blog post from the Royal College of Obstetricians and Gynaecologists (RCOG) is part of a series by IHA member organisations.
In this piece, Dr Ranee Thakar, RCOG president, explores why a whole-government focus on health inequalities is crucial to sustainably improving the health of women, girls, and people accessing obstetrics and gynaecology services in the UK.
The wider conditions of women’s lives – like having enough money to eat healthy food, access to affordable and good-quality housing, and living in a healthy local environment – play a fundamental role in supporting good health.
When women lack these resources, they are at greater risk of poorer health outcomes. A healthy diet, for example, can be prohibitively expensive for poorer households. Poverty is linked to increased chronic stress and poorer mental health, while insecure or inflexible work, and costly childcare and transport options, provide practical barriers to accessing healthcare. This is unfair and avoidable.
Many women, and those of us working in women’s health, can attest to the individual, devastating impacts unequal outcomes can have on women and their families. A Black woman is more than three times more likely to die during pregnancy than a white woman, and an Asian woman twice as likely. The inequality is starkly borne out in geographical data too – in England, women living in the most deprived areas have a life expectancy eight years shorter than those in the least deprived areas, and they are more than twice as likely to die during or shortly after pregnancy.
The new UK government has the unmissable opportunity to take a whole-government approach to end inequalities in women’s health. Prioritising their manifesto commitment to tackling the social determinants of health across every department is fundamental to delivering sustainable improvements to women’s health, and delivering their incredibly important ambition to end the Black and Asian maternal mortality gap.
Below, I set out three pressing and deliverable areas of focus that would make a real difference to women’s health.
Addressing the root causes of poverty and deprivation
Action to tackle the causes of inequalities in women’s health requires coordinated and collective efforts from all parts of government. This is why the IHA’s recommendation for a cross-government strategy to reduce health inequalities, which is appropriately funded and considers the role of every government department, is so vital for improvements in women’s health.
The RCOG’s new statement on poverty, deprivation and women’s health sets out other achievable actions, from taking an intersectional approach to improving employment opportunities and rights, to strengthening the Healthy Start scheme, ensuring everyone can access healthy food during pregnancy.
Evidence-based action to support population health
Supporting women's ability to maintain good health and make decisions about their reproductive, preconception, and pregnancy health requires government policy that supports public health. The new government has the opportunity to quickly introduce overdue secondary legislation to restrict TV and online advertising for less healthy food and re-introduce the Tobacco and Vapes Bill, which could quickly help to improve pregnancy outcomes.
We also need to see a reversal of the severe real-terms cuts to the public health grant over the last 10 years, which have hit sexual and reproductive health services hard.
Focus on climate change environment and local environment
Climate change and pollution are a real and increasing threat to women’s health, in the UK and further afield. Things like extreme weather and rising food costs can really exacerbate health inequalities, as those with fewer resources to call on are less able to respond, and more deprived communities are often exposed to higher levels of air pollution and associated health risks.
The government must consider the gendered impacts of climate change and pollution, particularly on reproductive health and health in pregnancy, and take robust action that truly protects everyone’s health.
The Royal College of Obstetricians and Gynaecologists (RCOG) works to improve women’s healthcare across the world and is committed to developing the accessibility and quality of education, training and assessments for doctors wishing to specialise in obstetrics & gynaecology. The RCOG is a member of the Inequalities in Health Alliance (IHA), convened by the RCP, which is campaigning for a cross-government strategy to reduce health inequalities.
Read the RCOG’s policy position statement on poverty, deprivation and women’s health.
This piece is part of a series of guest blog posts by members of the Inequalities in Health Alliance.