Healthcare inequalities: does where you live matter?

A recent study using Next Steps has revealed disparities in how young people access healthcare services, with those in less affluent neighbourhoods facing longer waits for emergency treatment and making less use of outpatient care.  

What we asked you 

When we caught up with you for the Age 25 Survey, we asked you for permission to link information from the NHS, including about your use of A&E and outpatient services, to your Next Steps study records. Nearly 5,000 of you agreed to this.  

A team of researchers, led by Imperial College London, analysed this NHS data alongside the information you shared with Next Steps about your lives when you were teenagers.  

What the researchers found 

The researchers found that young people’s experiences of NHS emergency and outpatient services, at age 16-17, differed depending on where they lived. This had more of an impact on people’s interactions with healthcare services than lifestyle factors such as smoking, drinking and playing sports.  

Young people in less well-off areas tended to access emergency healthcare more than their counterparts in wealthier neighbourhoods but they also experienced longer waits in A&E on average.  

In contrast to this, those living in affluent areas were more likely to use specialist outpatient care compared to young people in less advantaged neighbourhoods. In particular, looking at the experiences of people with similar healthcare needs, the researchers found that in poorer regions they were less likely to use mental health and orthodontic hospital care than those living in more advantaged parts of the country.  

Why this research matters 

This research shows people’s experiences of accessing healthcare services differ, depending on where they live.  

Examining the potential implications of this, lead author, Dr Mario Martínez-Jiménez (Imperial College London) said:

“If less advantaged teenagers are more likely to visit emergency rooms rather than use outpatient services, they are less likely to receive more nuanced and effective treatment. Given that young people from poorer backgrounds face worse overall health, this means there is a risk they could get caught in a cycle of poor health and insufficient treatment.” 

Dr Martínez-Jiménez highlighted the importance of policies that take account of these geographical disparities and suggested that better support for parents living in more deprived areas would also benefit their teenage children.  

He added:

“By addressing these barriers to people’s good health over the longer term, we could make progress towards a healthier, fairer and more productive society.”  

This research highlights the value of linking information held by other organisations, like the NHS, to your Next Steps survey records, with your consent. Doing this helps to build a fuller picture of your lives and produces new evidence on the challenges and inequalities some face.    

Find out more about this research 

Socioeconomic deprivation, health and healthcare utilisation among millennials by Mario Martínez-Jiménez, Bruce Hollingsworth and Eugenio Zucchelli was published in Social Science and Medicine in June 2024.