Inequalities and Inclusion

Health and wellbeing are not evenly distributed, and averages can conceal a wide range of individual need and condition. In most cases, improving the condition of the ‘worst off fastest’, is the most effective way to improve the health of the whole population.

Perhaps the most far-reaching inequality is that typically measured on the index of multiple deprivation (IMD), which includes (at a community, rather than individual, level) factors including income, education, employment and crime. In policy, the IMD is used to identify the 20% of most deprived communities in the NHS ‘Core20PLUS5’ programme. And the most comprehensive measures of the impact of factors affecting health are life expectancy, and healthy life expectancy, as shown below:

Key indicator: Healthy life expectancy at birth (male)

Key indicator: Healthy life expectancy at birth (female)

The geographical patterns of all mortality under 75 in Somerset are shown in the map below, taken from the OHID Local Inequalities Explorer Tool, which provides data and analysis of a range of inequalities.  The Somerset patterns show the relationship between disadvantage measured in the Index of Multiple Deprivation and ill-health.

All causes under 75 standardised mortality rate 2016 to 2020

Inequality has many dimensions, and whilst low income is significant as a cause and consequence of unfairness in society it is only part of the picture. Some inequalities are those considered in the Equality Act 2010, for which evidence is shown in the Somerset Intelligence Equality and Diversity webpage. Other groups, such as people with Special Educational Needs and Disability, people in rural areas and members of the military community, also have distinctive health conditions.

Somerset Health and Wellbeing Board has examined how other dimensions of inequality play out in Somerset in the following extended reports.

Next: Population