Our JSNA chapters consider the current and future health and social care needs of specific topics.

You can download the following topic-specific chapters as accessible Word documents:


There are differences in health outcomes between males and females, older and younger people, ethnic groups, and across geographical areas. These are known as health inequalities.

Health inequalities are unfair and avoidable differences in health status between groups of people or communities. They arise because of the conditions in which people are born, grow, live, work and age. These conditions influence a person’s opportunities for good health and affect how an individual thinks, feels and acts. Together these shape their health and wellbeing.

The characteristics of people or places associated with differences in health outcomes can be divided into 4 categories:

Category Examples
Protected characteristics
  • age
  • sex
  • race
  • religion or belief
  • sexual orientation
  • disability.
Socio-economic groups
  • people living in deprived areas
  • unemployed
  • low income.
Vulnerable groups
  • people experiencing homelessness
  • sex workers
  • vulnerable migrants
  • Gypsy and Roma Travellers.
  • built and natural environment
  • urban or rural areas.

There is a clear social gradient in health. This means that people in disadvantaged groups often die sooner and spend more years living with disabilities. While we should aim to reduce health inequalities across all society, actions must be focused and increased in proportion to the level of disadvantage. Improving the lives of those with the worst health, fastest.

Reducing health inequalities is a matter of fairness and social justice. Everyone deserves the same opportunities to lead a healthy life, no matter where they live or who they are.