In December, Office of National Statistics (ONS) published a new health index for England, and opened a consultation for feedback.
The index was first proposed in December 2018 by the then Chief Medical Officer Sally Davies, in her report Health 2040 – Better Health Within Reach as a new measure that would reflect the impact of the multiple factors that shape our health, with the suggestion that it be considered by Government alongside GDP, in recognition that a nation’s health should be an indication of its success.
The experimental Health Index provides a single value for health showing how health changes over time. It categorises health into three areas: Healthy People, Healthy Lives and Healthy Places. Healthy Places includes many of the social determinants of health (housing, green spaces and other elements of our surroundings such as air pollution). Other important social determinants of health including employment and education and training come under ‘Healthy Lives’ (framed as personal circumstances). Healthy People includes mental health and wellbeing, as well as physical health outcomes.
The publication of the index is significant because, as The Health Foundation’s Director of Health Jo Bibby says in her recent blog, “in publishing the index the government has unequivocally laid out the connection between the country’s health and factors such as poverty, housing and green space.”
From the Trust’s perspective as a local funder focused on resident led approaches, a key limitation of the Index in its current form is that it reports on data at Local Authority level, rather than neighbourhood level which means whilst it picks up important regional inequalities, it misses the complexities and inequalities that exist within individual Local Authority areas, which is most pronounced in big cities, as well as inequalities between different population groups.
However as Director of Public Health for Salford Dr Muna Abdel Aziz pointed out at The Health Foundation’s webinar on the Index, it is also significant that the tool frames health as an asset. The data visualisation tool is an accessible tool that enables users to look up their Local Authority and see visually how it compares. If the index could in the future report at neighbourhood level, it would no doubt have more potential to serve as an important tool for communities to use to influence and call for improvements to some of those social determinants of health that we know make a difference, such as access to green space.
Given the stark health inequalities that exist in England and links between health and wealth that have been further exposed by the COVID-19 pandemic, it is a vital time for Government to be measuring health and looking beyond GDP as a measure of success.
Find out more: Read the blog from Jo Bibby, Director of Health at The Health Foundation exploring the opportunities and challenges surrounding the ONS Health Index.
People's Health Trust responded to the consultation in March 2021.