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Stark health variation within councils could help chiefs refocus efforts

Healthy life expectancy rates vary gravely not just between the most and least deprived areas of the country, but also between the most and least deprived areas within local council areas, Public Health England (PHE) has revealed.

A new Office for National Statistics (ONS) report produced in conjunction with PHE pointed to high levels health inequalities in England. It was the first time such an analysis has been done, looking at figures nationally and within local authority.

The study, while stark, hopes to help health professionals across councils to learn where they need to focus their efforts, down to very small geographies.

Prof John Newton, chief knowledge officer at PHE, said the findings reinforced the need to address inequalities through public health and prevention, as all the evidence shows that “the root causes of health inequalities like these lie largely outside the health service”.

Dr Ann Marie Connolly, deputy director for health equity and mental health at PHE, said these differences emerge from inequalities in daily life, including people’s income, living standards, educational attainment and access to services.

These in turn drive unhealthy behaviours, like smoking, poor diet and physical inactivity, she said.

And Newton added: “The other big issue is that inequalities are greater for years of life lived in ill-health. People are living longer with one or more diseases like diabetes or cancer that might in the past have been fatal. This is a new situation for care services and has implications for how and where the resources those services need to be allocated in future.”

The local authorities with the widest inequalities in both life and healthy life expectancy are mostly located in the north west, Yorkshire and the Humber and some inner parts of London.

Some councils with wide health inequalities also have low overall life expectancy across the authority as a whole. These areas are largely dominated by metropolitan areas in relatively deprived parts of the north west, north east, Yorkshire and the Humber and the West Midlands.

By contrast, authorities in London were particularly prone to low overall healthy life expectancy but narrow inequalities.

Overall, the number of years a person could expect to live in good health in 2009 to 2013 in England was around 64 years – but marked health variations meant that this could decrease by a whopping 17 years in more deprived regions.