The UK Health Security Agency (UKHSA) has published its 2025 report on health inequalities in England, revealing a stark picture of how social and economic disadvantages continue to drive disproportionate health outcomes across the country.
This landmark document explores how people’s backgrounds, ethnicities, and where they live significantly influence their exposure to health risks – particularly infectious diseases and environmental hazards.
The report not only highlights the scale and impact of these health inequalities in England, but also outlines actions being taken to create a fairer, healthier future for all.
What are health protection inequalities?
Health protection involves safeguarding people and communities from infectious diseases, environmental threats, and other public health emergencies. However, protection is not distributed equally. Some groups are more vulnerable due to long-standing structural factors, such as poverty, housing conditions, access to healthcare, education, and systemic discrimination.
The 2025 report examines how these factors intersect and lead to unequal health outcomes. In short, people living in disadvantaged circumstances are more likely to get sick, be hospitalised, and die from preventable diseases.
Key findings from the 2025 report
-
Socioeconomic status plays a major role
- People in the most deprived 20% of areas in England are nearly twice as likely to be admitted to hospital for infectious diseases compared to those in the least deprived 20%.
- The burden is particularly severe for certain diseases:
These figures highlight how deprivation increases exposure to infectious disease risks, reduces access to timely care, and exacerbates the consequences of illness.
-
Ethnic disparities are profound
Ethnicity remains a powerful element of health outcomes in England.
- Emergency hospital admissions for TB are disproportionately high among certain ethnic groups compared to White British people:
- ‘Asian Other’ groups: 29 times higher
- Indian groups: 27 times higher
- Black African groups: 15 times higher
- Five ethnic groups showed consistently higher emergency admission rates for infectious diseases overall, driven by a combination of:
- Structural inequalities (such as poorer housing and job security)
- Cultural and language barriers
- Discrimination within healthcare systems
- Targeted underfunding in ethnic minority communities
-
Geography matters
Where someone lives in England significantly affects their exposure to health risks.
- The North West of England experiences the highest rate of emergency admissions for infectious diseases – 1.3 times the national average, and over 1.5 times higher than in the South East.
These regional variations are linked to:
- Economic deprivation
- Industrial legacies (e.g. poor air quality)
- Access to healthcare services
- Urban density and housing quality
-
Environmental hazards hit hardest in deprived areas
Beyond infectious diseases, people in deprived areas are more exposed to environmental health threats, including:
- Air pollution
- Radiation
- Chemical exposure
- Poor housing and overcrowding
These environmental stressors often act as amplifiers for underlying health conditions such as asthma, cardiovascular disease, and cancer, increasing both their prevalence and severity.
-
Vulnerable groups face unique barriers
So-called “inclusion health groups” – such as people experiencing homelessness, those in prison, asylum seekers, and people who inject drugs – are disproportionately affected by infectious diseases.
- Over 80% of people living with chronic Hepatitis C in England have a history of injecting drug use.
- Homeless populations face high rates of diseases such as TB and hepatitis due to crowded living conditions, poor nutrition, and limited access to primary healthcare.
- Asylum seekers often lack access to culturally appropriate or language-accessible health services, delaying treatment and increasing risk of spread.
These groups are often missed in mainstream healthcare planning and need dedicated strategies to ensure their health protection.
The economic cost of inequality
These inequalities aren’t just a moral and public health issue — they have a significant financial cost.
- In the year 2022–23, the NHS spent between £970 million and £1.5 billion on emergency hospital admissions for infectious diseases.
- A large portion of this spend is attributable to avoidable admissions, which could be reduced through targeted prevention, community outreach, and early intervention.
Reducing health inequalities in England isn’t just about fairness; it’s also essential for the long-term sustainability of the healthcare system.
UKHSA’s response: A four-pillar strategy
Recognising the complexity of the problem, UKHSA has set out a clear strategic framework to tackle health inequalities through:
-
Data-driven insights
- Improving data collection and analysis on inequalities, particularly regarding ethnicity, geography, and social deprivation.
- Using this information to identify high-risk communities and design more responsive services.
-
Collaborative action
- Partnering with local authorities, the NHS, voluntary organisations, and community groups to deliver place-based solutions.
- Ensuring communities are actively involved in designing and delivering services tailored to their needs.
-
Workforce capability
- Developing a skilled, diverse public health workforce capable of engaging with varied communities and responding effectively to inequality.
- Providing training on health equity, anti-discrimination, and culturally competent care.
-
Health equity as standard
- Embedding a “health equity lens” in all health protection policies and interventions, meaning every decision considers how to reduce disparities and promote fairness.
Looking forward
The findings of the 2025 UKHSA Health Inequalities in Health Protection Report are clear: urgent, targeted action is needed to prevent further widening of health gaps in England.
Health inequalities in England are not inevitable. With informed policymaking, community-driven interventions, and commitment across all sectors, it is possible to create a society where everyone – regardless of income, ethnicity, or postcode – has an equal chance at a healthy life.
As the UKHSA moves forward with its strategy, the challenge will be translating this comprehensive data and analysis into tangible, lasting improvements for those who need them most.
Access the full report here: Health Inequalities in Health Protection Report 2025
