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The average life expectancy... hides significant variation based on where you live.. ...and the quality of life your fellow citizens lead Health and social inequality In Brighton and Hove

Health inequalities - Brighton

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Page 1: Health inequalities - Brighton

The average life expectancy...

hides significant variation based on where you live..

...and the quality of life your fellow citizens lead

Health and social inequality

In Brighton and Hove

Page 2: Health inequalities - Brighton

This slideshow looks at Brighton and Hove and is based on ‘Fair Society Healthy Lives’, a landmark report by Professor Marmot

1. Key indicators of health inequalities laid down by the Marmot report

2. Indicators relating to the social determinants of health inequalities

Children achieving a good level of

development aged 5

Young people not in employment,

education or training

People in receipt of means tested

benefits

Means tested benefits by area of

deprivation

The Marmot report covers much more, including a detailed range of policy initiatives

Show me

The slideshow is divided into two parts:

Page 3: Health inequalities - Brighton

In Brighton and Hove the average life expectancy at birth is 77.7 years for men and 83.2 for women

Data for years 2008 to 2010

Page 4: Health inequalities - Brighton

But those living in the most deprived areas of Brighton and Hove have a lower life expectancy compared to those in the more affluent areas

Most deprived areas

Least deprived areas

Decile range

The inequality in male life expectancy(years) in Brighton and Hove between the most and least deprived areas

6.6The inequality in female life expectancy(years) in Brighton and Hove between the most and least deprived areas

10.6

Data for years 2006 to 2010

Area based deprivation is often measured tenths or ‘Deciles’ using the Indices of Deprivation. Inequalities in income and wealth translate into residential segregation.

Page 5: Health inequalities - Brighton

And the inequality in ‘disability-free life expectancy’ (DFLE) is even greater

The inequality in male life expectancy (years) between the most and least deprived areas

6.6 The inequality in female life expectancy (years) between the most and least deprived areas

The inequality in Disability -free life expectancy (years) for men between the most and least deprived areas

9.1

11.9

Disability-free life expectancy (DFLE) is the average number of years a person can expect to live without an illness or health problem that limits their daily activities. An inequality of 11.9 years means that a DFLE for the best off in Brighton and Hove is nearly 12 years higher than for the worst off.

Those living in areas of high deprivation not only die earlier but also spend more of their years coping with a disability

The inequality in Disability -free life expectancy (years) for women between the most and least deprived areas

10.6

Page 6: Health inequalities - Brighton

The geography of inequality

See heatmap to check which decile your neighbourhood

falls into. You can also click on an area of the map for

more information

Click here to go to interactive map

Inequalities in wealth and wealth translate into residential segregation. Differences in house prices, rents and tenure along with the labour market act as a sifting process.

The result is that the most vulnerable and those with the least choices are often concentrated together in the least desirable areas.

Page 7: Health inequalities - Brighton

Health inequalities result from social inequalities

Social inequality indicators used to predict health outcomes*

Children achieving a good

level of development

aged 5

Young people not in employment,

education or training

People in receipt of means tested

benefits

Means tested benefits by area of

deprivation

The London Health Observatory (LHO) and the UCL Institute of Health Equity have produced the following key indicators relating to the social determinants of health outcomes

Page 8: Health inequalities - Brighton

In Brighton and Hove 64.5% of children achieved a good level of development at age 5 (Year 2011)

The highest priority in the Marmot Review is the aim to give every child the best start in life, as this is crucial to reducing health inequalities across the life course.

Children achieving a good level of

development aged 5

Young people not in employment,

education or training

People in receipt of means tested

benefits

Means tested benefits by area of

deprivation

indicators used to predict health outcomes

As the foundations of human development are laid in early childhood, the review proposed an indicator of readiness for school to capture early years development.

The percentage of children achieving a good level of development is presented for this indicator, based on the local authority where each child was living, rather than the location of the school. As LAs are only required to report results for the schools and nurseries they maintain, results may be affected for this indicator, for some areas, if a large proportion of their child population is in private schools.

Page 9: Health inequalities - Brighton

In Brighton and Hove 8.4 % of young people are not in employment, education or training (NEETs)

Non-participation of young people in education, employment or training between the ages of 16 and 19 is a major predictor of later unemployment, low income, depression, involvement in crime and poor mental health

Children achieving a

good level of development

aged 5

Young people not in

employment, education or

training

People in receipt of

means tested benefits

Means tested benefits by area of deprivation

This was recognised in the Marmot Review which proposed an indicator to measure young people not in education, employment or training in order to capture skill development during the school years and the control that school leavers have over their lives. This indicator is therefore a wider measure than just youth unemployment as it also includes young people who are not being prepared for work

indicators used to predict health outcomes

Page 10: Health inequalities - Brighton

In Brighton and Hove, 15.3% of people were in receipt of means tested benefits (Year 2008)

Children achieving a

good level of development

aged 5

Young people not in

employment, education or

training

People in receipt of

means tested benefits

Means tested benefits

The importance of reducing income inequality, and the negative consequences of relative poverty, was emphasised in the Marmot Review, which noted that: “An adequate and fair healthy standard of living is critical to reducing health inequalities. Insufficient income is associated with worse outcomes across virtually all domains, including long-term health and life expectancy.” (page 120)22.1% : the percentage of children under 16 living in poverty in Brighton & Hove (defined as living in families whose reported income is less than 60% of the median income) see HM Revenue site

indicators used to predict health outcomes

Page 11: Health inequalities - Brighton

The figure for means tested benefits(15.3%) masks significant variations between areas of high and low deprivation – the Slope Index of Inequality

Children achieving a

good level of development

aged 5

Young people not in

employment, education or

training

People in receipt of

means tested benefits

Means tested benefits by area of deprivation

The Slope Index of Inequality summarises the social inequality found in each local authority area. The higher the percentage, the greater the inequality within the local authority.

The figure for Brighton 28.3% (year 2008) represents the difference in percentages between the least and most deprived areas within the local authority, based on a statistical analysis of the relationship between the percentage in receipt of means-tested benefits and deprivation scores across the whole authority.

indicators used to predict health outcomes

Page 12: Health inequalities - Brighton

The figure for means tested benefits (15.3 %) broken down by area of deprivation

Children achieving a

good level of development

aged 5

Young people not in

employment, education or

training

People in receipt of

means tested benefits

Means tested benefits by area of deprivation

For example those areas falling into the bottom decile (decile 10) have a far higher concentration of their population on benefits (around 37%) compared to decile 1 (around 6%)

indicators used to predict health outcomes

Page 13: Health inequalities - Brighton

The social indicators below are a predictor of the health outcomes above

Children achieving a good level of

development aged 5

Young people not in employment,

education or training

People in receipt of means tested

benefits

Means tested benefits by area of

deprivation

The London Health Observatory (LHO) and the UCL Institute of Health Equity have produced the following key indicators relating to the social determinants of health outcomes

The average life expectancy... hides significant variation based on where you live..

...and the quality of life your fellow citizens lead

To summarise:

Page 14: Health inequalities - Brighton

Doing nothing is not an option

• £31-33 billion in productivity losses  

• £20-32 billion  in lost taxes and higher welfare payments

• costs in excess of £5.5 billion in additional  NHS healthcare costs every year

The Marmot report outlines a range of policy initiatives from early years education to a minimum income for healthy living.

Those who claim that such policies are unaffordable  in the present economic climate, must weigh that claim against the cost of doing nothing:  

Marmot

report

Page 15: Health inequalities - Brighton

HEAT MAP SHOWING INDEX OF MULTIPLE DEPRIVATION FOR YOUR AREA

This presentation also comes with a heat map showing small area based levels of deprivation in your local authority area. This uses the Index of Multiple Deprivation data which both the Marmot report and the UCL Institute of Health Equity refer to.

The map is there to make it easier for you to refer and compare different neighbourhoods in your area. It includes a radial graph showing the seven domains of deprivation that go to make up the Index of Multiple Deprivation. For technical reasons both the map and radial graph reverse the number range contained in the Marmot report: Decile 1 is now least deprived and Decile 10 = most deprived.

This is so that the data is aligned to the Decile range shown in the accompanying heat map and radial graph.

Additional notes

Page 16: Health inequalities - Brighton

YOU ARE FREE TO DOWNLOAD AND USE THIS SLIDESHOW AS A TEMPLATE FOR YOUR OWN LOCAL AREA

Slideshow by Gavin Barker

www.gavin-barker.comKEY SOURCESLondon Health Observatory

UCL Institute of Health Equity

Should you do so, please delete my name and substitute the picture in slide 14. To embed a section of the map in your website, please contact me [email protected]

Use the data for your local authority located at the London Health Observatory This is available for upper tier local authorities in England only (excluding the City of London and Isles of Scilly)