The Trust responded to the Office for National Statistics’ consultation on a new Health Index to say we welcomed its arrival, noting it would complement our day-to-day work.
While the Trust works at a neighbourhood level, we noted that local authority-level analysis would give a useful broader context which would support our research and evaluation work. The Trust proposed the Health Index add a layer of analysis to focus down at a more local level, by LSOA and MSOA, to offer neighbourhood level analysis. This is the level at which it is clearest to identify health inequalities, and local authority-level analysis can mask smaller pockets of disadvantage.
We identified issues with the groupings of categories in the Healthy People and Healthy Places criteria the beta version of the Index presented, as it conflated socio-economic determinants of health with clinical issues such as cancer screening rates, behavioural and psychological risk factors, and sexual health. These are important metrics, but their categorisation did not logically follow the draft guidance to support the Index. The Trust called for greater clarification here to improve the user journey.
The Trust also highlighted the lack of consideration of protected characteristics such as ethnicity, gender and disability, which are key to understanding health inequalities. Amendments made following the publication of the full Index have partially allayed this concern. We also suggested the inclusion of food bank use and free school meal uptake data, given food security is a key indicator for health.
The Trust also advocated for clearer presentation to be given to life expectancy, healthy life expectancy and disability-free life expectancy gaps, given this data is included within the calculations of the Index’s scores. These are some of the clearest and easiest to interpret measures of health inequalities between different places.
The final version of the ONS Health Index was published on 18 March 2022 here.