Correction: it was found that the measure used for the unemployment rate indicator for unitary authorities was based on the standard Labour Force Survey measure of unemployment instead of the ONS model-based estimate of unemployment. The values for previously published time periods (2013 to 2015) have been changed to the model-based unemployment estimates, in line with the newly published 2016 values. This only effects unitary authorities: county councils, regions and England remain the same. District level authorities have been added to this profile for the first time in this update (7th November 2017) and so are not affected.

Introduction

Welcome to the Wider Determinants of Health tool. The tool is an ongoing project and will continue to be developed over time. As such, some sections of the tool are currently more developed than others. We would be happy to hear from you to inform this development: you can email us at wider.determinants@phe.gov.uk if you have any feedback.

About

Wider determinants, also known as social determinants, are a diverse range of social, economic and environmental factors which impact on people’s health. Such factors are influenced by the local, national and international distribution of power and resources which shape the conditions of daily life. They determine the extent to which different individuals have the physical, social and personal resources to identify and achieve goals, meet their needs and deal with changes to their circumstances. The Marmot review, published in 2010, raised the profile of wider determinants of health by emphasising the strong and persistent link between social inequalities and disparities in health outcomes. Variation in the experience of wider determinants (i.e. social inequalities) is considered the fundamental cause (the ‘causes of the causes’) of health outcomes, and as such health inequalities are likely to persist through changes in disease patterns and behavioural risks so long as social inequalities persist. Addressing the wider determinants of health has a key role to play in reducing health inequalities, one of PHE’s core functions.

Several studies have attempted to estimate the contribution of the wider determinants to population health, finding that wider determinants have a greater influence on health than health care, behaviours or genetics. It is therefore an important aspect of public health in terms of informing preventative action and reducing inequality. In addition, both the Marmot review and the Dame Carol Black review highlighted the huge economic costs of failing to act on the wider determinants of health.

Aims

The aim of the profile is to provide the public health system with intelligence regarding the wider determinants of health to help improve population health and reduce health inequalities. This Fingertips profile aims to:

  • provide a set of indicators which describe a range of wider determinants of health and enable a comparison of these factors between areas
  • highlight relationships between wider determinants and other risk factors and health outcomes
  • provide, where possible, links to further resources for tackling wider determinants. This may take the form of best practice, case studies, interventions, guidance, or links to other data tools or analyses.

Further resources

Recent updates

November 2017

New indicators added:

  • Employment support allowance claimants
  • Access to healthy assets and hazards index
  • Workplace injury
  • Affordability of home ownership.

Updated indicators:

  • Unemployment
  • Children in the youth justice system
  • Employment rate
  • Fuel poverty
  • Excess winter deaths
  • Gap in the employment rate between those with a long-term health condition and the overall employment rate
  • Sickness absence - % of employees who had at least one day off in the previous week
  • Sickness absence - % of working days lost due to sickness absence
  • Statutory homelessness: Households in temporary accommodation
  • Statutory homelessness: Eligible homeless people not in priority need
  • Social Isolation: adult social care users who have as much social contact as they would like
  • Mortality rate from causes considered preventable
  • Under 75 mortality rate from all cardiovascular diseases
  • Under 75 mortality rate from cancer
  • Under 75 mortality rate from liver disease
  • Under 75 mortality rate from respiratory disease.

New materials have been added to the Further Resources section.

October 2017

New materials have been added to the Further Resources section.

August 2017

The following indicators have been updated:

  • Sickness absence - % of employees who had at least one day off in the previous week
  • First time entrants to the youth justice system
  • First time offenders
  • Pupil absence

New materials have been added to the Further Resources section.

May 2017

New indicators added:

  • Density of fast food outlets
  • Air pollution: fine particulate matter
  • Economic inactivity rates.

New data in the Marmot domain:

  • Individuals not reaching the Minimum Income Standard
  • Inequality in life expectancy at birth
  • 19-24 year olds not in education, employment or training
  • Long-term claimants of Jobseekers Allowance.

New links added in the 'Further resources' section.

New functionality: local authority and regional population pyramids.

March 2017

  • Marmot indicators updated
  • Wider Determinants of Health tool launched