New figures published this week from the Institute of Health Equity suggest health inequalities are set to rise. The Marmot Indicators 2014 finds that poor results, in particular for children’s development and ensuring incomes are sufficient for people to live healthy lives, are likely to lead to increases in health inequalities in the future.
The Marmot Indicators 2014 have been developed in collaboration with Public Health England. They are a new set of indicators of the social determinants of health, health outcomes and social inequality that broadly correspond to the policy recommendations proposed in Fair Society, Healthy Lives: The Marmot Review report, published in February 2010.
Taking a range of Marmot indicators together, it is clear that, in general, health is poorest in the North of the country, where social determinants are worse, although there are specific problems of inequity in London, such as the difficult of being able to afford a healthy life.This links with the publication of Due North: The report of the Inquiry on Health Equity for the North, which makes recommendations for how to address health inequalities in the North of England, including increasing the influence of the public in determining how resources are used to improve health, and increased involvement of the health sector in promoting health equity.
The Marmot Indicators identify that approximately 2.5 million (5.8%) of adults aged over 16 had low levels of self-rated life satisfaction in 2012-13, ranging from 3.4% in Surrey, to 10.1% in Knowsley. There is a relationship between well-being and deprivation – more people are likely to live with low levels of life satisfaction in more deprived areas.
The Marmot review noted that it was important, for health, for people to be able to afford a healthy life. These are the costs associated with, for example, having a nutritious diet, adequate clothing, and enough money for heating. There has been deterioration in living standards, with the proportion of people living in households with income below the Minimum Income Standard (MIS) increasing by a fifth between 2008/9 and 2011/12, from 3.8 million to 4.7 million households, 23% of households. In London, where costs are higher, more than one in four households (29.4%) did not receive enough income.
Just 52% of children achieved a good level of development at the end of reception in 2012/13 and only 36% of those with free school meal (FSM) status achieved a good level of development at the end of reception.
Data for the 2014 indicators can be accessed by local authority on the following factors:
- Healthy life expectancy at birth – males and females
- Life expectancy at birth – males and females
- Inequality in life expectancy at birth – males and females
- People reporting low life satisfaction
- Good level of development at age 5
- Good level of development at age 5 with free school meal status
- GCSE achieved (5A* – C including English and Maths)
- GCSE achieved (5A* – C including English and Maths) with free school meal status
- 19-24 year olds who are not in employment, education or training
- Unemployment % (ONS model-based method)
- Long-term claimants of Jobseeker’s Allowance
- Work-related illness
- Households not reaching Minimum Income Standard
- Fuel poverty for high fuel cost households
- Percentage of people using outdoor places for exercise/health reasons