Health Inequalities

Health inequalities arise when there are measurable differences in the health of different populations, according to classifications such as deprivation, sex, socio-economic status, geography or other health measures such as smoking status.

Inequalities in health may not necessarily be inequitable. Health inequalities occur when services, opportunities and access provided to some populations do not meet their health needs as well as those provided to others (Shaw et al, 2007). The Marmot review set out to determine "the most effective evidence-based strategies for reducing Health inequalities in England from 2010". The resulting report, links health inequalities to social determinants of health and health risks and recommends six policy objectives that aspire to reduce health inequalities.
Health inequalities in Yorkshire and the Humber are addressed in the The big opportunity report.

YHPHO tools, data and resources

Health Inequalities in Yorkshire and Humber

Much work in the determination of health inequalities often focuses on variations in life expectancy at birth as a health outcome. YHPHO has created two products that measure progress in reducing differences in life expectancy at birth, both within PCTs and between the PCTs and England.

Wider determinants of health profiles for Local Authorities in Yorkshire and the Humber

These profiles summarise some of the work of the larger wider determinants of health report linked to the Marmot Review, which aims to support action on the wider determinants of health.

Life expectancy at birth dashboards for spearhead PCTs

This collection of dashboards depict the progress made by each PCT that is co-terminous with a spearhead authority in the Yorkshire and Humber Region, in reaching targets in life expectancy and all age, all cause mortality. A range of other indicators are also included which help to give further insight into what may be contributing to local life expectancy figures.

A gives a brief overview on how to interpret the dashboard. More detailed descriptions of the indicators used can be found in the metadata file.

Life expectancy gap profiles for PCTs

This collection of life expectancy profiles for each Primary Care Trust (PCT) in the region and the region as a whole, were part of a programme of work aimed at supporting local organisations in identifying key priorities for tackling health inequalities. The profiles linked closely with, and built upon, the APHO Health Inequalities Intervention Toolkit, but provided additional elements:

• analysis produced for all PCTs;
• analysis looking at PCT-level and within-PCT variation;
• analysis over a five-year period (2003-07) compared to 2001-05;
• comparisons with the spearhead group of PCTs.

Maps of deprivation for Yorkshire and Humber districts

Maps of the Index of Multiple Deprivation 2010 have been produced for the region and for each district within the region. These maps aim to highlight where the population lives as well as the more and less deprived areas.
Access the maps of deprivation

APHO lead area

Each PHO takes the lead for a key policy area. Please visit the APHO website for further details about lead areas.

London Health Observatory is the lead public health observatory for health inequalities in England. Their web page on health inequalities looks at the different types of health inequality; policies and intervention and gives an overview of resources, tools and data.

Health Inequalities Intervention Toolkit

The Toolkit is designed to support Primary Care Trusts with their Local Delivery Planning and commissioning. It builds on the previous Health Inequalities Intervention tool which provided information for Spearhead areas only, and now includes all local authorities, spearhead and non-spearhead, and provides information on within as well as between area inequalities.

Local Basket of Indicators

The main purpose of the Local Basket of Health Inequalities indicators is to help support local action to achieve the Government’s national inequalities targets for life expectancy & infant mortality, by highlighting information relevant to addressing the targets and assisting local areas with monitoring progress towards reducing health inequalities.

Further resources

The APHO Health Profiles show life expectancy at birth for each local authority and quintile in Yorkshire and Humber, along with other community, lifestyle and health indicators.

The Health Poverty Indexenables users to visualize health poverty in one or two local authorities by means of a spider diagram based on 25 indicators

The Slope index of inequality (SII) for life expectancy at birth was chosen to be the health inequalities indicators in the World Class Commissioning Assurance Framework. It represents the absolute gap in life expectancy at birth between the most deprived and least deprived decile in each PCT, ranked by the Index of Multiple Deprivation 2007.

References and further reading

Marmot, M. (2010) Fair Society Healthy Lives: a strategic review of health inequalities in England post 2010.
Shaw, M., Galobardes,B., Lawlor, D., Lynch, J., Wheeler, B. and Davey Smith, G. (1994) The handbook of inequality and socioeconomic position; concepts and measures. 1st ed. Bristol: The Policy Press
Wilkinson, R. and Pickett, K. (2009) The Spirit Level: why more equal societies almost always do better. 1st ed. London: Penguin
Carr-Hill,R. and Chalmers-Dixon, P. (2005) The Public Health Observatory Handbook of Health Inequalities http://www.sepho.org.uk/Download/Public/9707/1/Carr-Hill-final.pdf [Accessed 10 August 2010].
UK National Statistics (2010) Topic guide to: health inequalities http://www.statistics.gov.uk/hub/health-social-care/health-of-the-population/health-inequalities [Accessed 10 August 2010].

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Last Updated: Friday, 25th November 2011