Health inequalities

Health inequalities refer to the differences in health outcomes that are closely linked to social, economic, and environmental disadvantages. These differences are systematic, avoidable, and unfair.

We aim to consider health inequalities as part of every workstream and at every stage of the cancer pathway.

It is particularly important in our aim to improve the earlier diagnosis of cancer as there is a 7.4% gap in early diagnosis between the more affluent and most deprived areas of our patch.

How health inequalities affect cancer incidence

Exposure to risk factors

• Living conditions: people in lower-income communities may be more exposed to cancer-causing substances like air pollution, secondhand smoke, or industrial chemicals.
• Workplace hazards: jobs that involve exposure to carcinogens (e.g. asbestos, diesel fumes) are more often held by people from disadvantaged backgrounds.

Access to healthy environments

• Food access: lack of affordable, nutritious food can lead to poor diets, which increase the risk of certain cancers.
• Green space & exercise: safer, greener neighbourhoods encourage physical activity, which is protective against cancer.

Healthcare access

• Prevention & Screening: people from marginalized groups may face barriers to cancer screening (like mammograms or colonoscopies), leading to delayed detection.
• Early Treatment: delays in diagnosis often result from systemic issues, not personal choices.

Cultural and structural barriers

• Mistrust in healthcare systems: Historical and ongoing discrimination can lead to mistrust, causing people to avoid seeking medical help early.
• Language & literacy barriers: Health messages and resources may not be accessible to those who don’t use English as their first language or those with lower literacy, reducing awareness of symptoms and risk factors.

Cancer incidence is influenced far more by structural factors—such as poverty, education, employment, housing, and healthcare access—than by individual behaviour alone. Recognising the role of health inequalities allows us to address the root causes of increased cancer risk in certain communities, and geographies, and reduce the barriers for them in accessing healthcare for detection and treatment.

Examples of our recent health inequalities projects

• Work to remove barriers to cancer screening programmes for ethnically diverse communities
• Work with farming communities to raise awareness of cancer in rural communities and with fisherman in coastal areas
• Work to increase the return rate of diagnostic tests from people living in more deprived areas
• Project to enable the use of a diagnostic test by people with a sensory impairment
• Work to track the reasonable adjustments needed for people with serious mental illness to enable them to access diagnosis and treatment.
• Pilot of an intensive support approach for people with multiple and complex needs to enable them to access services