Productive Healthy Ageing Profile - Inequalities

Inequalities

The following selected resources can be used to provide insight into and support reduction in ageing inequalities. Includes sections: 'Inequalities Overview'; 'Ethnic Minorities'; 'Lesbian, Gay, Bisexual, Transgender & Queer (LGBTQ+)' and 'Disabilities'.

Inequalities Overview

Covid-19 impact:

• The COVID-19 Health Inequalities Monitoring in England tool (CHIME) to monitor the direct impacts of COVID-19, such as on mortality rates and hospital admissions, with data broken down by age, sex, ethnic group, deprivation level and region. Published by Public Health England.
• Wider impacts of COVID-19 on health monitoring tool - to monitor the wider impacts of COVID-19 across a range of relevant topics. The majority of indicators are broken down by age group, and many are broken down by deprivation level, ethnic group, region or other inequality measures. Published by Public Health England.
• COVID-19: public health - 'Health Inequalities' - other 'data tools' and further resources to support local areas'. A collaboration between Public Health England, the Local Government Association, Association of Directors of Public Health, NHS England & NHS Improvement.
• COVID-19 and Social Exclusion: Experiences of older people living in areas of multiple deprivation (2021) - a report based on research undertaken by members of the Manchester Urban Ageing Research Group
• Build Back Fairer: The COVID-19 Marmot Review (2020) produced by the UCL Institute of Health Equity and commissioned by the Health Foundation
• Excess mortality in English regions (2020) broken down by age, sex, upper tier local authority, ethnic group, level of deprivation, cause of death and place of death published by Public Health England
• COVID-19: review of disparities in risks and outcomes (2020) report and accompanying data pack published by Public Health England
• Mitigating the wider health effects of covid-19 pandemic response (Douglas,M. et al, 2020) published in the Lancet. Includes a data supplement.  
  

General resources:

• The summary of the indicators in this profile descibes the available inequality breakdowns and also signposts other PHE tools where versions of the indicators are available for comparison at GP practice or small area level 
• Inequality Tools published by Public Health England. Use the 'Segment Tool' to explore the contributions of different causes of death & age groups to inequalities in life expectancy.
• Socioeconomic inequalities in avoidable mortality: England analysis – annual analysis published by the Office for National Statistics
• Inequalities in later life published by the Centre for Ageing Better
• Health Equity - collection of resources published by Public Health England
• Voluntary, Community and Social Enterprise (VCSE) Health and Wellbeing Alliance - "a partnership between voluntary sectors and the health and care system to provide a voice and improve the health and wellbeing for all communities" 
• See also the Employment further resources section
• See also the Carers further resources section

General publications by year:

• Gender differences in countries' adaptation to societal ageing: an international cross-sectional comparison (Chen, C., Maung, K. & Rowe, J.W., 2021). The Lancet Healthy Longevity 2(8), e460-e469. https://doi.org/10.1016/S2666-7568(21)00121-5.
• Ageing in coastal and rural communities - Exploring the factors underlying health inequalities for older men, older people from ethnic minorities, and older LGBTQ+ people (2021) published by Public Health England and Age UK
• Understanding and addressing inequalities in physical activity (2021) published by Public Health England
• UK Poverty 2020/21 (2021) - annual report published by the Joseph Rowntree Foundation
• In Focus: Experiences of Older Age in England (2020) - report and further resources focussing on the experiences of specific groups of older people (low income, BAME, carers, without children, physical health, mental health) published by Independent Age
• Health Equity in England: The Marmot Review 10 Years On (2020) published by the Health Foundation
• Health inequalities in ageing in rural and coastal areas (2019) - an evidence summary published by Public Health England
• Health inequalities: place-based approaches to reduce inequalities (2019) - guidance published by Public Health England
• A different age: A snapshot of diverse later lives (2019) published by the International Longevity Centre UK
• Palliative and end of life care: hospital deaths 2006 to 2017 (2019) - variation and trends by age group and CCG, cause of death and place of death published by Public Health England
• Deaths in people aged 75 years and older in England in 2017 (2019) - variation and change by age group, sex, cause of death, place of death, deprivation and marital status published by Public Health England
• Health Profile for England: 2019 - includes chapter on inequalities in health published by Public Health England
• Health Matters: Ambitions to tackle persisting inequalities in cardiovascular disease (2019) published by Public Health England
• PHE Screening’s inequalities strategy (2018) published by Public Health England
• Inequalities Matter (2018) published by the International Longevity Centre UK
• Guidance - Health inequalities: reducing inequalities in local areas (2017) published by Public Health England
• Inequalities in later life: The issue and the implications for policy and practice (2017) published by the Centre for Ageing Better

Ethnic minorities

Several resources in the Inequalities Overview section above highlight inequalities experienced by people from ethnic minority groups. The websites and publications below provide more focussed information:

Ethnic minorities - websites:

• Ethnicity facts and figures - including data on various health topics and wider determinants of health published by the Race Disparity Unit
• UK population by ethnicity - data based on the 2011 census published by the Office for National Statistics. Includes national and regional populations, with age breakdowns provided for England and Wales. ONS has produced later year modelled estimates by age and sex and down to local authority level but with strong caveats regarding use - see publications below.
• Ethnicity - various analyses undertaken by the Office for National Statistics 
• NHS Race and Health Observatory - announcement May 2020 of the creation of a new research centre to investigate the impact of race and ethnicity on people’s health, to be hosted by the NHS Confederation 
  
• Race Disparity Unit - part of the Cabinet Office with a role to "collect, analyse and publish government data on the experiences of people from different ethnic backgrounds" and "support government departments in driving change where disparities are found".
• Race Equality Foundation - "seek to explore discrimination and disadvantage, and use that knowledge to help overcome barriers and promote race equality in health, housing and social care"

Ethnic minorities - publications by year:

• Ethnicity coding in English health service datasets (Scobie, S., Spencer, J. & Raleigh, V, 2021) - a research report published by the Nuffield Trust and supported by the NHS Race and Health Observatory
• The report of the Commission on Race and Ethnic Disparities (2021)
• Ethnic inequalities in health-related quality of life among older adults in England: secondary analysis of a national cross-sectional survey (Watkinson, R.E., Sutton, M. & Turner, A.J., 2021). The Lancet - Public Health, Vol 6 (3), E145-E154. DOI: https://doi.org/10.1016/S2468-2667(20)30287-5
• What do the latest analyses from ONS and PHE tell us about ethnic inequalities in COVID-19? (2020) - blog published on the Office for National Statistics website
• COVID-19: pre-existing health conditions and ethnicity (2020) published by Public Health England
• Updating ethnic contrasts in deaths involving the coronavirus (COVID-19), England and Wales: deaths occurring 2 March to 28 July 2020 (2020) published by the Office for National Statistics
• COVID-19: understanding the impact on BAME communities (2020) published by Public Health England. See also relevant links in the Indicators Overview - Covid-19 Inpact section at the top of this page.
• Population denominators by broad ethnic group and for White British, local authorities in England and Wales: 2011 to 2019 (2020) including by single age and sex published by the Office for National Statistics - but note caveats in the 'supporting information' document
• Coronavirus (COVID-19) related deaths by ethnic group, England and Wales: 2 March 2020 to 10 April 2020 (2020) published by the Office for National Statistics
• Ethnicity and COVID-19: an urgent public health research priority (Pareek, M. et al, 2020) - correspondence published in the Lancet
• In Focus: Experiences of BAME older people (2020) published by Independent Age
• Research report on population estimates by ethnic group and religion (2019) published by the Office for National Statistics
• Population denominators by ethnic group, regions and countries: England and Wales, 2011 to 2018 (2018) - including by single age and sex published by the Office for National Statistics - but note caveats in the 'supporting information' document
• Guidance - Health inequalities: reducing ethnic inequalities (2018) published by Public Health England
• Dementia and black and minority ethnic carers (2018) published by the Race Equality Foundation
• Dementia and end of life care for black, Asian and minority ethnic communities (2018) published by the Race Equality Foundation
• Population estimates by ethnic group (2017) article on methods used to generate estimates published by the Office for National Statistics 
• Evandrou, M. et al (2016). Ethnic inequalities in limiting health and self-reported health in later life revisited - published in the Journal of Epidemiology & Community Health

Lesbian, Gay, Bisexual, Transgender & Queer (LGBTQ+)

Population estimates:

• Sexual orientation, UK published by the Office for National Statistics - annual bulletin and accompanying data tables providing experimental population estimates by region, age, sex, marital status, ethnicity and socio-economic classification
• Subnational sexual identity estimates, UK: 2013 to 2015 (2017) published by the Office for National Statistics - experimental estimates but only for a limited number of local authorities due to sample sizes

General:

• LGBT Information and Advice published by Age UK
• The National LGB&T Partnership - "reducing health inequalities and improving access to health and social care for LGB&T people"
• Older Lesbian, Gay, Bisexual & Trans Association (OLGA) - a "voluntary group whose main aim is to support the needs of the older lesbian, gay, bisexual and trans community"
• It's more important than ever to listen to older LGBT+ voices (2021) - a blog published by the Centre for Ageing Better highlighting both the organisation's 'Ageing with pride' campaign providing stories from older people and also innovative developments in Manchester
• Ageing in coastal and rural communities - Exploring the factors underlying health inequalities for older men, older people from ethnic minorities, and older LGBTQ+ people (2021) published by Public Health England and Age UK
• New models of community are needed to give LGBT+ people a good later life (2019) - article published by the Centre for Ageing Better
• Safe to be me. Meeting the needs of older lesbian, gay, bisexual and transgender people using health and social care services (2017) published by Age UK - a resource pack for professionals.
• Diversity in older age – Older Lesbian, Gay and Bi-sexual people and Older Transgender people (2016) a rapid review published by the Centre for Policy on Ageing

Disabilities

Disabilities - regularly updated data sources:

• Family Resources Survey - annual report including UK data on disabilities by age published by the Department for Work and Pensions
• Projecting Older People Population Information (POPPI) System - includes age groups over age 65 estimates and projections at local authority level by support arrangement, health condition and learning disability. Published by Oxford Brookes University and the Institute of Public Care.
• Projecting Adult Needs & Service Information (PANSI) for ages 18-64 - includes age 45-54 and 55-64 estimates and projections at local authority level by learning disability and physical disability. Published by Oxford Brookes University and the Institute of Public Care.#
• Learning Disability Profiles - local authority level data tool published by Public Health England
• Health and Care of People with Learning Disabilities - data at CCG, STP and region level published by NHS Digital 
• Disability Facts and Figures published by SCOPE

Disabilities - publications by year:

• Making the extra years count: Inequalities in disability and dependency with increasing longevity (2021) - recording of a virtual policy event hosted by the International Longevity Centre UK
• Coronavirus and the social impacts on disabled people in Great Britain: February 2021 published by the Office for National Statistics
• Outcomes for disabled people in the UK: 2020 (2021) providing data and analyses aross a range of topics, with the majority covering ages 16-64, published by the Office for National Statistics
• COVID-19: deaths of people with learning disabilities (2020) published by Public Health England
• Guidance - Care and support of people growing older with learning disabilities (2018) published by the National Institute of Health and Care Excellence (NICE)
• Learning disability: applying All Our Health (2018) published by Public Health England - guidance for healthcare professionals
• Diversity in older age - Disability (2016) a rapid review published by the Centre for Policy on Ageing
• Research and analysis: People with Learning Disabilities in England 2015 (2016) published by Public Health England
• Local action on health inequalities: Increasing employment opportunities and retention for people with a long-term health condition or disability (2014) published by Public Health England

Disabilities - general websites:

• COVID-19: Supporting autistic people and people with learning disabilities - guidance published by the Social Care Insititute for Excellence (SCIE)
• Coronavirus and mental health, learning disabilities and autism - guidance published by NHS England and NHS Improvement
• Disabled people - links to a range of resources published on the .gov website
• Office for Disability Issues - part of the Department for Work and Pensions
• Ageing and Disability published by the United Nations
• Disability Rights UK  - "We are disabled people leading change, working for equal participation for all"
• AbilityNet - a national charity that "exists to change the lives of disabled people by helping them to use digital technology at work, at home or in education"
• SCOPE: a national "disability equality charity" that aims to "provide practical information and emotional support when it's most needed" and "campaign relentlessly to create a fairer society"
• Disabled Living Foundation - "a national charity providing impartial advice, information and training on equipment for independent living"
• Health & Wellbeing Alliance: Valuing People Alliance - "committed to improving the health & well-being of all people with learning disabilities"
• Ageing Well published by the British Institute of Learning Disabilities (BILD)
• See also the Housing further resources section