Health inequalities in London

Date 31 August 2017
Date updated 25 May 2018

There are differences in health outcomes between those on the highest and lowest incomes. This relationship between socio-economic circumstances and health is a graded one – that is the higher the social-economic position, the better the health. These differences in health are not just caused by genetics, behaviour or difficulties accessing medical care. They reflect, and are caused by, social and economic inequalities in society. 

Inequalities in health exist across a range of social and demographic indicators, including income, social class, occupation, housing condition, neighbourhood quality, geographic region, gender and ethnicity. Inequalities are evident in many health outcomes, including mortality, morbidity, self-reported health, mental health, death and injury from accidents and violence. This set of indicators covers: infant mortality, childhood obesity; premature death; and life expectancy at birth without a limiting long-term condition or illness for men and women. 

The rates of infant mortality and premature death in London fell between 2011 and 2015. However, child obesity rates have continued to rise, up to 23% in London. This is 3% higher than the national figure.

Health: Indicators

Infant mortality over time

Infant mortality* in London and England from 2001–03 to 2013– 15. Infant mortality is a sensitive measure of the overall health of a population. It is an indicator of the association between the causes of infant mortality and other factors which influence the health of a population, such as economic development, living conditions, well-being and rates of illness.** In 2013–15 infant mortality in London was 3.4 per 1,000 live births, which was lower than the England average of 3.9. 

The infant mortality rate has come down since 2001–03 in both England and London. However, in 2001–03, London had a marginally higher rate than England (5.7 to 5.4), and Inner London (6.3) had a much higher rate than England. Outer London was lower at 5.2. 

In the course of just over a decade, there has been a large fall in infant mortality rates in both London …

Infant Mortality by borough

The boroughs with the highest infant mortality rates, of above 4 per 1,000 live births, are found in Inner East and South East London, plus Barking & Dagenham and Greenwich. This is higher than the London and the England rates. 

These boroughs have not seen much improvement. With the exception of Southwark and Greenwich, none of these boroughs were in the bottom 10 for infant mortality a decade ago. However, because they saw no improvements whereas other boroughs have, they have dropped down the rankings. Southwark has improved from 7 per 1,000 live births in 2003–05 to 4 per 1,000, a large improvement. 

Hackney had the highest infant mortality rate at 5.4 per 1,000 live births. This is more than twice the rate than in the nine boroughs with the lowest infant mortality rate. Havering’s rate is 2 per 1,000 live births and Waltham Forest…

Premature mortality by borough

Premature mortality, measured as the number of deaths of those aged 55 to 64 years old per 100,000 of the population by borough. In 2015, the rate of premature deaths was 566 per 100,000 in London and 613 in England on average. This is lower than the rate in 2011, which was 686 in London and 797 in England. The rate has fallen more quickly in England than in London so they are now much closer than five years ago. A Public Health England study found that between 1990 and 2013 there was a large increase in life expectancy in England. The increase was mainly because of falls in the death rate from cardiovascular disease, stroke, chronic obstructive pulmonary disease and some cancers.* There have been improvements in the treatment of these diseases and the introduction of national preventative programmes.** 

There is once again a great deal o…

Child Obesity 2

The proportion of Year 6 students (age 11) in each borough who are counted as obese in 2015/16. In London as a whole, 23% of Year 6 students were obese. This is a higher rate than in England, where 20% of Year 6 students were obese. Both London and England experienced a slight increase over the last five years (one percentage point). Across the boroughs, the change has been uneven. Eight have seen an improvement with the level of childhood obesity falling, while in eight boroughs there has been an increase of more than 3%. 

In 2015/16 there were nine boroughs – Westminster, Enfield, Waltham Forest, Hackney, Tower Hamlets, Southwark, Newham, Greenwich and Barking & Dagenham where at least a quarter of children in Year 6 were obese. In 2010/11 there were only six boroughs where at least a quarter of children were obese. 

Barking & Da…

Expected years without limiting conditions at birth (women)

The number of years women can expect to live at birth without a limiting long-term condition or illness for the years 2013–2015. The life expectancy without a long-term condition dataset is created using a self-reported measure of disability. It asks if the respondent has a long-term illness or disability and if this limits their daily activities. This means, for example, that a person who was born deaf but who did not feel that this limited their daily activities would not be included in the calculations whereas a person who became deaf and felt that this limited their daily activities would be. Health expectancies are a measure of overall population health at different geographies and give an indication of the wellbeing of society. It is important that there are differences in life expectancy but the quality of life people experience i…

Life expectancy for men

This map shows the life expectancy without a limiting long-term condition for men at birth for the years 2013–2015. Life expectancy without a long-term condition at birth was 64.1 years for London between 2013 and 2015. This was above the England average which was 63 years. As noted above, the measure is subjective and it depends on the respondent’s experience of their illness or disability. There is variation between men and women but it is possible that some of this variation is due to these groups reporting differently. 

However, this hides a huge variation between the different London boroughs. In Tower Hamlets, the borough with the lowest life expectancy without a long-term condition, men can only expect to live 54 years without a long-term condition. Whereas in Kingston – the borough with the highest life expectancy without disabili…