An official version of the Office for National Statistics (ONS) Health Index for England, a beta version of which was published in December 2020, has been published with updates following a consultation.
The purpose of the Index is to simply define what makes up our health. It provides a single value for health for local areas and demonstrates how health changes over time. It places an emphasis on the social determinants of health – the everyday social and economic factors which make us healthy. The Index also includes more traditional measures of health such as specific conditions and risk factors. The idea is that providing a simple index that brings together all of these diverse influences on health outcomes will make it easier to understand where interventions are needed and to track their success more effectively.
This version of the Index follows a number of recommendations called for by the Trust, with many having been adopted including data being made available for smaller geographical areas.
People’s Health Trust responded to the public consultation and supported the creation of the Health Index. Whilst it demonstrated a distinct shift to consider health as an asset and something which is largely determined by wider social and economic factors, the Trust made recommendations to expand the impact of the tool.
The Trust suggested neighbourhood level lower super outputs area (LSOA-level) data should be included to support local level analysis, rather than larger areas such as upper tier local authority areas. In this updated Health Index, whilst neighbourhood level data still isn’t available, lower-tier local authority area data has been included.
The Index categorises health into three areas: Healthy People, Healthy Lives and Healthy Places, which include some of the social determinants of health such as housing, green spaces, employment, and education.
Responding to the consultation, the Trust advocated for greater weight given to the wider determinants of health in recognition of their importance in health creation. We also suggested it needed clearer descriptions of the Index and plainer-language guidance for how it can be used in order to support its use, which ONS has taken on board.
Two new indicators included in the March 2022 Health Index are internet access and low-level crime. Three concepts from the beta version were removed, including low pay (the percentage of employees earning below the National Living Wage) which is an important indicator of health inequality. It is unclear why this has been lost. Data on social relationships is also missing, despite clear evidence of the importance of social connections to health.
The updated Health Index can now be used to track health data locally from 2015 to 2019 to inform decisions and for analysis. The methodology will be used to produce Health Index Data for 2020 which is due to be published this year. As the Health Foundation outlined in their recent blog, it will enable local leaders to give evidence on drivers of health and provides a common language for communities and government to talk about health and how to improve it. The complexities and inequalities that exist within neighbourhoods can be vast and the Health Index is an important step to develop a greater understanding of factors which impact our health.