We often refer to socioeconomic deprivation and health inequality without distinguishing between them. Although they are interrelated, socioeconomic deprivation in the UK is usually measured using the Index of Multiple Deprivation (IMD), of which one element is ‘health deprivation’. Health inequality is characterised variously as the relative difference between groups of people (defined usually by some small area geography) in terms of Life Expectancy, or Healthy Life Expectancy or one of a number of other measures.
The interplay between socioeconomic deprivation and health inequality is complex. There are four areas in our region that have merited specific community development efforts due to being both deprived and having poorer health outcomes than other communities.
Risks to health and wellbeing are not evenly distributed across the population, but instead conspire to form patterns of inequality with people in poverty more likely to experience poor health, partly because of living in poorer environmental conditions.
If inequalities are to be reduced, it is critical that risks are identified early on in their development and, where possible, action is taken to lessen their impact on health and wellbeing. This requires services to actively seek out groups of people known to be at heightened risk, as they may be the ones least likely to seek help from services or participate in health programmes. The earlier that these risks can be identified and preventative measures put in place, the better the outcomes for health and wellbeing.
As well as impacting on biological health, society affects health in a number of ways, directly and indirectly and by influences on the healthcare system:
- directly, through violence, injury, rape and other offences against the person
- indirectly, through the psychological and physical consequences of injury, victimisation and isolation because of fear
- as a determinant of illness, along with poverty and other inequalities, which increases the burden of ill health on those communities least able to cope
- by causing preventable health burdens, such as alcohol-related crime, motor vehicle incidents and drug dependency
- structurally by limiting the choices people are able to make – healthy food costs more, working life makes it difficult to access services unless out-of-hours, poor education makes it difficult to access health information and reduces social-mobility chances etc.
There are well established links between health, employment, productivity and poverty. Being in work provides purpose, promotes independence and is a factor in preventing physical and mental health problems.
Promoting health and well-being for all will raise employment, reduce child poverty and poverty later in life, and raise the growth in productivity of the British economy. Similarly, increasing employment and opportunity of employment will directly promote better health and well-being for all.
The Economy (JSNA April 2016) is one of seven narratives of the Dorset Joint Strategic Needs Assessment that aim to understand the health and wellbeing needs of our local population. Key findings from the Economy JSNA are:
- over 34,000 people of working age in Dorset claim out of work benefits 8% of Dorset’s working age population are claiming out of work benefits. (Department for Work and Pensions, May 2015)
- of those claimants, 26,000 people claim Employment Support Allowance/Incapacity Benefit and are likely to face significant barriers to employment
- 49% of those claiming sickness-related benefits had mental and behavioural disorders as their primary health condition. Bournemouth (59%) had the highest rate of claimants with Dorset (45%) and Poole (44%) having similar rates
- ill-health and injuries cost an estimated £180 million to Dorset LEP economy during 2012/13. (Health and Safety Executive, 2014/15)
- Dorset’s workforce is ageing. 109,600 people or 32% of the workforce population were aged 50 or over in the Dorset LEP area. In comparison, for England it was 28%
- in 2015, there were some 76,000 employee jobs paid less than the living wage in the Dorset LEP. At least 46,000 of these jobs were part-time jobs
Bournemouth, Poole and Dorset are part of the Dorset Local Economic Partnership (LEP). Dorset LEP is led by the private sector and aims to promote local economic growth and prosperity. For further information about the LEP and its economic strategy please see the website Dorset Local Enterprise Partnership.
Indicators of inequality for our region have been drawn from the Wider determinants of health and the Public Health Outcomes Framework (PHE).
* indicates a statistically significant difference from the respective English Average.