The right to health and health inequalities: time for change

Former UN special rapporteur on the right to health, Paul Hunt, underlines that the realisation of the right to health would translate to a situation where ‘disadvantaged individuals and communities enjoy, in practice, the same access as those who are more advantaged’.

However, this is not the reality in the UK: health inequalities are widening, and health injustice is pervasive. 

On 10 December, Human Rights Day, Just Fair published a new report on the right to health in the UK, which argues that it is time to put the rights at the centre of positive change.

The right to health

Achieving the right to health is about creating a world where everyone can access quality healthcare, regardless of where they live, how much they earn, their gender, age, ethnicity or other personal characteristics. 

The right to health is also about people enjoying universal access to various factors that improve physical and mental health, like adequate housing, sufficient and nutritious food, green spaces, fair and equitable working conditions, healthy relationships and a healthy environment.  

However, this is not the reality among many across the UK.

The problem

The reasons are stark, and include the following:

• The UK government has not been sufficiently resourcing the provision of quality healthcare that meets the needs of all
• The availability, accessibility and quality of publicly provided healthcare are deteriorating
• Privatisation and commercialisation are having negative effects on the provision of quality health and social care that meets the needs of all
• Increasing racism, poverty, exposure to poor housing conditions, and the effects of migration status and climate change are negatively impacting certain groups and communities’ access to both healthcare and healthy living environments.

The right to health is also about people enjoying universal access to various factors that improve physical and mental health, like adequate housing, sufficient and nutritious food, green spaces, fair and equitable working conditions, healthy relationships and a healthy environment.

However, this is not the reality among many across the UK.

The impact on health inequalities

While these factors can potentially impact everyone, they are affecting some marginalised groups more than others, further compounding differences in health outcomes.

For instance, people living in poorer areas of Scotland are three times more likely to die earlier or have more years of ill health than those in richer areas.

Likewise, structural racism impacts health in direct and indirect ways. In fact, Black women are four times more likely, and Asian women twice as likely, to die in childbirth than White women in the UK. Gypsy, Roma and Traveller communities also experience significant barriers to accessing healthcare and poorer maternal health outcomes.

Disabled people are more likely to experience discrimination, have poor access to some health services, and have worse employment prospects, all of which are barriers to maintaining healthy lives. During COVID-19, people with learning disabilities were six times more likely to die during the pandemic than the general population in England.

Furthermore, climate change disproportionately impacts marginalised groups and those with pre-existing health conditions. For example, half of the poorest households in England live in homes that are the most likely to overheat. Climate change may also increase age-related mental health inequalities, with eco-anxiety being on the rise among the youngest.

Discrimination can also be multi-layered and create cumulative disadvantage. 

For instance, poverty continues to impact people’s health and lives. For the first time in 100 years, life expectancy has declined for the poorest 10% of women.

The solution

To start to address health inequalities and other issues from a human rights perspective, the Just Fair report argues that we must embed the right to health at the core of UK law and policy – specifically:

• economic, social and cultural rights, including the right to health, must be incorporated into UK domestic law and effectively implemented
• Section 1 of the Equality Act 2010 – the socio-economic duty – must be enacted and effectively implemented.

It is time for everyone in the UK to enjoy quality healthcare, access to adequate living and working conditions, and a healthy environment, not as a privilege but as a right.

This piece is part of a series of guest blog posts by members of the Inequalities in Health Alliance.