Groundwork UK

BLOG: Calling for action on health inequalities

Groundwork exists to promote healthier, happier, and greener communities across the UK. At present, the chances of living a long and healthy life are heavily determined by geographical location and socio-economic factors. The Covid-19 pandemic has highlighted these inequalities, making the need for action even more urgent.


That’s why Groundwork’s CEO, Graham Duxbury, has signed a letter from the Inequalities Health Alliance to the Prime Minister, calling for a cross-government strategy to tackle health inequality. This is an issue that disproportionately affects the most disadvantaged communities, including many of the people Groundwork works with every day. By supporting this call to reduce and address underlying health inequalities which affect many parts of the UK, we hope to encourage the government to act on factors which shape the health of the population.

What is health inequality?

Health inequality is the difference in health between different groups of people. There are lots of different measures of health and lots of different ways that inequalities can present themselves. It can include differences in life expectancy, differences in chances of getting a particular health condition, and differences in mental health, wellbeing, and life satisfaction. These differences are a result of systemic inequalities that exist in our society, which means that it is possible to undo them – and doing so is a question of fairness.

Prior to the pandemic, health inequalities were present throughout the UK. A landmark report published in February 2020 found that the health gap between wealthy and deprived areas had widened over the previous decade. Improvements to life expectancy had stalled, and even declined for the poorest 10% of women.

During the pandemic, experts highlighted that many deaths could have been prevented if people had better general health. Poorer people and people with pre-existing health conditions were among the highest affected by covid-related deaths and there were also disparities between people from different ethnic backgrounds. The high levels of covid-related deaths during 2019 caused a drop in life expectancies where there was a greater fall in all deprivation groups (1).

What is Groundwork doing?

Groundwork aims to empower people to improve and manage their health and create environments that support healthy lives. We have a long history of working with communities and public health colleagues nationally and locally to help transform the lives of the disadvantaged communities in the UK – helping thousands of people to improve their health, wellbeing, and local environment.

Groundwork’s projects and services impact health and wellbeing in three main ways:

  1. Tackling ill-health through public health projects

For example, the Cook Together Eat Together programme was developed to tackle social isolation and poor nutrition among elderly residents in Coventry. Groundwork runs social cooking courses, accompanied by guidance and support from a dietician which helps participants make decisions about the food they eat. Following the courses, 92% of residents reported improved skills and confidence of how to prepare and cook food, 78% reported an increase in positive mood and wellbeing. The project has proved successful in tackling social isolation and poor diet which directly affects their health.

  1. Creating settings and local environments that support good health

The physical environment in which we live plays an important role in our health and Groundwork works with communities to create spaces that support good health. For example, community gardens like Grozone provides a place for local people to come together, reducing social isolation and loneliness while providing access to nature which has well documented benefits for mental and physical health. People from all walks of life are welcomed, and the garden community prides itself on being an inclusive space for those with learning difficulties and mental health issues. Volunteers work together to grow and cook fresh food, spend time in the fresh air and learn new skills. The team also work with local people to improve the local environment in Northwich, spreading the benefits far beyond the garden itself.

  1. Tackling the wider determinants of health like employment and housing

One of the ways we do this is through Groundwork’s Green Doctors service, which helps keep households stay warm and well while reducing their bills and carbon emissions. Fuel poverty affects 13.4% of the UK population (2), meaning that many low-income households are at risk of having poor health and illnesses. Thousands of residents have benefitted from advice and help from Green Doctors. Green Doctors provide more than just advice – they enable residents in fuel poverty to have a better quality of life. Watch Clare’s story on how our Green Doctors helped her family through a tough winter.

Climate change and health

The UK, like the rest of the world, is already experiencing the impacts of climate change. The cold period in February 2018, nicknamed ‘The Beast from the East’, was responsible for causing 2,000 premature deaths. The UK is also experiencing increasingly hot summers, putting people at risk from heat related illness. These changes mean that services like Groundwork’s Green Doctors will be an essential part of ensuring residents can make practical adjustments to their homes to adapt to a changing climate.

Scientists have concluded with ‘very high confidence’ that climate change is already causing people to lose their lives in the UK and future risk is even higher (3). Increased frequency of extreme weather conditions and pollution will negatively affect health, with some direct mortalities associated with climate change (4). The scale of climate-related impacts on health will vary across geographical locations and population groups who are predicted to be more vulnerable. The older generation are predicted to be more vulnerable as they may be physically, financially, and emotionally less resilient to dealing with climate-related threats than the rest of the population (5).

Where next?

There have been some encouraging signs from government, recognising the importance of addressing the social determinants of health. The NHS’s Long Term Plan, published in January 2019, contained an increased focus on prevention and social prescribing (the idea of health practitioners referring people to community based activities and initiatives to improve patients’ health and wellbeing). However, recent funding announcements have had little to offer to public health or local authorities.

The government has recently announced a new Office for Health Improvement and Disparities will take over from Public Health England from October this year, which could signal a new focus on tackling health inequalities. We’ll be watching its progress closely, hoping to see the Inequalities in Health Alliance’s call for a cross-government strategy taken up.

Groundwork will continue to work with communities and individuals, creating the conditions to support good health and reducing the inequalities in health which exist today. Over the next six months, we are embarking on a project to bring together the insights from our work on health and wellbeing, and create a blueprint for healthier, happier, and greener communities – watch this space.

Blog written by Radya Syed, Groundwork’s Policy and Research Trainee


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