Inequalities are preventable, unfair and unjust differences in health status between groups, populations or individuals that arise from the unequal distribution of social, environmental and economic conditions within societies, which determine the risk of people getting ill, their ability to prevent sickness, or opportunities to take action and access treatment when ill health occurs.
Inequalities in health outcomes are present in Norfolk & Waveney. Local analysis has illustrated that rates of emergency hospital admissions are higher for people from the most deprived areas and people from these areas are more than three times as likely to die before the age of 75 compared with the most affluent areas, and this can be due to multiple factors, from inequalities in healthy lifestyle behaviours, living conditions, access and quality of health services and likelihood of living in poor health with long term conditions.
The Covid-19 pandemic has had an impact on inequalities. People from the most deprived areas and from minority ethnic groups are more likely to have been infected or have died with the disease. Younger people, people from deprived areas, in particular people from minority ethnic groups, have been less likely to access COVID19 vaccination services. lockdowns and disruption to education has had an impact on attainment and mental health for children and young people from more deprived backgrounds and wider implications for inequalities are just beginning to be understood.
Core20 populations in Norfolk and Waveney
Core20PLUS5 is a national NHS England and NHS Improvement approach to support the reduction of health inequalities at both national and system level. The approach defines a target population cohort – the ‘Core20PLUS’ – and identifies ‘5’ focus clinical areas requiring accelerated improvement.
The most deprived 20% of the national population as identified by the national Index of Multiple Deprivation (IMD). The IMD has seven domains with indicators accounting for a wide range of social determinants of health.
There are 42 communities across Norfolk and Waveney where some or all the population live in the 20% most deprived areas in England. However, none of these communities are in Broadland or South Norfolk. 40% of the populations of Great Yarmouth and Norwich live in the most deprived 20% of areas in England compared to 16% for Norfolk and Waveney as a whole.
Health Inequalities in Norfolk and Waveney (Public Health England, January 2020)
The Global Burden of Disease (GBD) Study 2017 highlights the conditions causing the largest burden (in terms of disability-adjusted life years) in Norfolk and Waveney.
The purpose of this slide set is to demonstrate inequalities in important high-burden diseases – defined either because they are high burden as measured by the GBD, or because they reflect a national strategic priority.
These slides include Local Health indicators where there is a particularly strong statistical linear relationship with deprivation as measured by the Index of Multiple Deprivation 2019 (IMD 2019) within Norfolk and Waveney.
It uses routinely available data from the Local Health website.
Health Inequalities Toolkit
The Health Foundation (2021) ‘Good Health is vital for prosperity, allowing people to play an active role at work and in their communities. Improvements in life expectancy stalled in the decade before the pandemic and there are wide inequalities in health within and between local areas in the UK’
It is widely acknowledged that there are health inequalities in the UK and that no one organisation or community can tackle them alone. Several factors influence how long someone lives, such as where they live, whether they have faced discrimination and what their employment prospects are.
The health inequalities toolkit is a resource to help place based organisations tackle health inequalities. It provides a step-by-step guide for organisations and communities which takes them to clear and considered action. The resources aid in clarifying the identified issue, it’s causes, what is happening right now in a place, and how communities can work together to address the existing poor health outcomes.
It can be used as a whole or in part, and contains validated national tools as well as links to further information, all stages are accessible from this webpage.