Authors:
- Dr James Durrand, RCoA Centre for Research and Improvement Fellow; Perioperative Quality Improvement Programme (PQIP); Resident Anaesthetist (ST6), South Tees Hospitals NHS Foundation Trust
- Dr Eimhear Lusby, Honorary Research Fellow, University College London; ST6 Anaesthetist, University Hospitals Sussex NHS Foundation Trust
- Dr Adam Hunt, MPhil/PhD Student, University College London and Resident Anaesthetist, The Royal Marsden NHS Foundation Trust
- Professor S Ramani Moonesinghe, PQIP Chief Investigator
The circumstances in which we are born, grow, live, work and age profoundly influence our health. These complex, reciprocal, and dynamic interactions begin in utero and develop continuously throughout life.
Recognition that socioeconomic deprivation drives poorer health was fundamental to the establishment of the UK NHS in 1948. The key causal relationships and how to intervene in them have been debated since then.
Seventy-five years later, people from more deprived backgrounds still experience less beneficial interactions with the NHS. Individuals present later and with more severe disease. Unhealthy behaviours, including smoking, physical inactivity and poor diet, are more common and often cluster. In turn, rates of chronic ill health and multimorbidity are higher. Wider advances in key disease areas have been unevenly distributed across socioeconomic groups. Consequently, deprived patients continue to die younger.