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The importance of talking about health inequalities

We spoke to Hayley Hall, a member of our Patient and Carer Network (PCN), about the need to keep the conversation flowing around health qualities.

Forward by Eddie Kinsella, chair of the PCN

The launch of the Inequalities in Health Alliance (IHA) has a particular resonance for the role of the Patient and Carer Network. Our fundamental purpose is to work in harmony with the Royal College of Physicians and a wide range of organisations to improve the health and wellbeing of the communities we serve. That purpose is best achieved through empowerment: engaging with patients and enabling individuals, particularly the most vulnerable and disadvantaged, to have their voice heard and to have greater influence on those circumstances which shape their lifestyle and wellbeing.

Professor Sir Michael Marmot starkly illustrates the widening gap between that noble aim and the reality of a wasted decade. As a society, we have failed thus far to address the ‘causes of the causes’ with a reduction in increases in life expectancy matched with an increase in the social gradient. The impact of COVID 19 reinforces that failure. However, the launch of the IHA provides the opportunity to give greater momentum to the campaign to create a fairer society.

Hayley Hall’s article is a wonderful example of this. Individually and collectively we can make a difference for the better. Things do not always have to be this way. To borrow unashamedly from Professor Sir Michael Marmot, we can apply ‘evidence-based optimism’ to the cause. The IHA can be the catalyst for improvement and the Patient and Carer Network will offer our full support.

Interview with Hayley Hall, PCN representative

Tell us a bit about yourself…

I live in Hexham, Northumberland. Long-term mental health issues led me to volunteering. Counselling last year made me realise that I needed a more balanced life, with less focus on work and more focus on the values I held. Most of my work had been related to healthcare (non-clinical) so I looked for voluntary work that would use my experience and support my belief that we should all have access to excellent healthcare. The RCP's Patient and Carer Network (PCN) was one of the first volunteer posts I applied for, and the detailed and informative joining process helped ensure we were a good fit. I enjoy the wide range of areas that the PCN is involved in and I look forward to becoming more involved. I also volunteer as a community engagement volunteer for Healthwatch Northumberland. This role has had to change because of COVID-19, but it’s been really interesting seeing how the team has adapted to a new way of working so positively.

I also set up The Hygiene Bank West Northumberland earlier this year. I knew about the national charity so when I saw they wanted local volunteers I filled in the form straight away. I was inspired by my own experiences; there have been times in my life when there just wasn’t enough money. I was lucky to have a lot of family support, but I remember times when I had to make choices about which ‘essential’ I would do without. We started the hygiene bank in April this year and we were lucky because we secured funding that helped us start out at a time when we couldn’t set up any donation points. We’ve used our funding to support community partners with essential hygiene products since then. We’ve supplied everything from nappies to shaving foam to washing up liquid and face wipes. We support our local food bank, a local youth project and a local community group and have plans to expand. We’re taking it slowly though as we need to be sustainable.

Why do you think it’s important to continue talking about health inequalities, particularly at the RCP?

Unfortunately, health inequalities aren’t going away. We saw the Institute of Health Equity publication earlier this year, Marmot Review 10 years on. The report concluded that inequalities have grown. For example, improvements in life expectancy have stalled and are in fact worse for some sections of society.

Such entrenched issues need action from all levels of society and over timescales that go beyond the short-time plans of most governments. Organisations such as the RCP are ideally placed to use the knowledge and skills of their members to highlight the impact of health inequalities and shape the debate on how improvements can be made; members of the PCN can provide invaluable support and insight into this work.

What do you think the key messages are for physicians and healthcare professionals in trying to address inequalities in health?

The wider determinants of health, such as access to housing, limit opportunities for some people to live healthy lives.

Socio-economic factors, such as income, create choices between essentials which can impact negatively on health.

People will experience the services you plan and provide in ways that you never imagined. Patient engagement can help you understand how to address this.

Interventions to help people change behaviours need to be realistic. You need to recognise the challenges that people face and the fact that they may not have some of the tools that you think everyone has.

This is one of a series of blogs to mark the launch of the Inequalities in Health Alliance, a coalition of organisations who have come together to campaign for a cross-government strategy to reduce health inequalities.