1. Health and social
inequality
In Brighton and Hove
The average life hides significant ...and the quality of life
expectancy... variation based on your fellow citizens lead
where you live..

2. This slideshow looks at Brighton and Hove and is
based on ‘Fair Society Healthy Lives’, a landmark
report by Professor Marmot
The slideshow is divided into two parts:
1. Key indicators of health inequalities laid down by the
Marmot report
2. Indicators relating to the social determinants of health
inequalities
Young people not People in receipt Means tested
Children achieving a
in employment, of means tested benefits by area of
good level of
education or benefits deprivation
development aged 5
training
The Marmot report covers much more, including Show
a detailed range of policy initiatives me

3. In Brighton and Hove the average life expectancy at birth
is 77.7 years for men and 83.2 for women
Data for years 2008 to 2010

4. But those living in the most deprived areas of Brighton and Hove have a
lower life expectancy compared to those in the more affluent areas
Data for years 2006
to 2010
Most deprived Decile range Least deprived
areas areas
10.6 The inequality in male life expectancy(years) in Brighton Area based deprivation is often
and Hove between the most and least deprived areas measured tenths or „Deciles‟ using the
Indices of Deprivation. Inequalities in
income and wealth translate into
The inequality in female life expectancy(years) in Brighton residential segregation.
6.6 and Hove between the most and least deprived areas

5. And the inequality in „disability-free life expectancy‟
(DFLE) is even greater
The inequality in male life The inequality in Disability -free
10.6 11.9
expectancy (years) life expectancy (years) for men
between the most and least between the most and least
deprived areas deprived areas
The inequality in female life The inequality in Disability -free
6.6 expectancy (years) between
9.1 life expectancy (years) for women
the most and least deprived between the most and least
areas deprived areas
Those living in areas of high Disability-free life expectancy (DFLE) is the average
deprivation not only die earlier number of years a person can expect to live without an
illness or health problem that limits their daily activities.
but also spend more of their An inequality of 11.9 years means that a DFLE for the
years coping with a disability best off in Brighton and Hove is nearly 12 years higher
than for the worst off.

6. The geography of inequality
See heatmap to check which
decile your neighbourhood
falls into. You can also click
on an area of the map for
more information
Click here to go to
interactive map
Inequalities in wealth and wealth
translate into residential
segregation. Differences in
house prices, rents and tenure
along with the labour market act
as a sifting process.
The result is that the most
vulnerable and those with the
least choices are often
concentrated together in the
least desirable areas.

7. Health inequalities result from social inequalities
Social inequality indicators used to predict health
outcomes*
The London Health
Observatory (LHO) and Children Young people not People in receipt Means tested
the UCL Institute of
Health Equity have
achieving a good in employment, of means tested benefits by area of
produced the following level of education or benefits deprivation
key indicators relating to development training
the social determinants aged 5
of health outcomes

8. In Brighton and Hove 64.5% of children achieved a good level
of development at age 5 (Year 2011)
The highest priority in the Marmot Review is
the aim to give every child the best start in
life, as this is crucial to reducing health
inequalities across the life course.
As the foundations of human development are laid in
early childhood, the review proposed an indicator of
readiness for school to capture early years
development.
The percentage of children achieving a good level of
development is presented for this indicator, based on
the local authority where each child was living, rather
than the location of the school. As LAs are only
required to report results for the schools and
nurseries they maintain, results may be affected for
this indicator, for some areas, if a large proportion of
their child population is in private schools.
indicators used Children achieving Young people not People in receipt Means tested
to predict health a good level of in employment, of means tested benefits by area of
outcomes development aged education or benefits deprivation
5 training

9. In Brighton and Hove 8.4 % of young people are not in
employment, education or training (NEETs)
Non-participation of young people in education,
employment or training between the ages of 16
and 19 is a major predictor of later
unemployment, low income, depression,
involvement in crime and poor mental health
This was recognised in the Marmot Review which
proposed an indicator to measure young people not in
education, employment or training in order to capture skill
development during the school years and the control that
school leavers have over their lives. This indicator is
therefore a wider measure than just youth unemployment
as it also includes young people who are not being
prepared for work
indicators used Children Young people People in Means tested
to predict health achieving a not in receipt of benefits by area
outcomes
good level of employment, means tested of deprivation
development education or benefits
aged 5 training

10. In Brighton and Hove, 15.3% of people were in receipt of
means tested benefits (Year 2008)
The importance of reducing income inequality,
and the negative consequences of relative
poverty, was emphasised in the Marmot Review,
which noted that: “An adequate and fair healthy
standard of living is critical to reducing health
inequalities. Insufficient income is associated
with worse outcomes across virtually all
domains, including long-term health and life
expectancy.” (page 120)
22.1% : the percentage of children under 16
living in poverty in Brighton & Hove (defined as
living in families whose reported income is less
than 60% of the median income) see HM
Revenue site
indicators used
to predict health
Children Young people People in Means tested
outcomes achieving a not in receipt of benefits
good level of employment, means tested
development education or benefits
aged 5 training

11. The figure for means tested benefits(15.3%) masks significant variations
between areas of high and low deprivation – the Slope Index of Inequality
The Slope Index of Inequality summarises the
social inequality found in each local authority
area. The higher the percentage, the greater
the inequality within the local authority.
The figure for Brighton 28.3% (year 2008) represents
the difference in percentages between the least and
most deprived areas within the local authority, based
on a statistical analysis of the relationship between
the percentage in receipt of means-tested benefits
and deprivation scores across the whole authority.
indicators used
to predict health
Children Young people People in Means tested
outcomes achieving a not in receipt of benefits by area
good level of employment, means tested of deprivation
development education or benefits
aged 5 training

12. The figure for means tested benefits (15.3 %) broken down by
area of deprivation
For example those areas falling into
the bottom decile (decile 10) have a far
higher concentration of their population
on benefits (around 37%) compared to
decile 1 (around 6%)
indicators used
to predict health
Children Young people People in Means tested
outcomes achieving a not in receipt of benefits by area
good level of employment, means tested of deprivation
development education or benefits
aged 5 training

13. The average life expectancy... hides significant variation ...and the quality of life your
based on where you live.. fellow citizens lead
To summarise:
The social indicators below are a predictor of the
health outcomes above
The London Health
Observatory (LHO) and
the UCL Institute of
Health Equity have
Children achieving Young people not People in receipt Means tested
produced the following
key indicators relating to a good level of in employment, of means tested benefits by area of
the social determinants development aged education or benefits deprivation
of health outcomes 5 training

14. Doing nothing is not an option
The Marmot report outlines a range of policy initiatives from
early years education to a minimum income for healthy living.
Those who claim that such policies are unaffordable in
the present economic climate, must weigh that claim
against the cost of doing nothing:
• £31-33 billion in productivity
losses
• £20-32 billion in lost taxes and
higher welfare payments
• costs in excess of £5.5 billion in
additional NHS healthcare costs
every year
Marmot
report

15. Additional notes
HEAT MAP SHOWING INDEX
OF MULTIPLE DEPRIVATION
FOR YOUR AREA
This presentation also comes with a
heat map showing small area based
levels of deprivation in your local
authority area. This uses the Index of
Multiple Deprivation data which both the
Marmot report and the UCL Institute of
Health Equity refer to.
The map is there to make it easier for
you to refer and compare different
neighbourhoods in your area. It includes
a radial graph showing the seven
domains of deprivation that go to make
up the Index of Multiple Deprivation. For
technical reasons both the map and
radial graph reverse the number
range contained in the Marmot report:
Decile 1 is now least deprived and
Decile 10 = most deprived.
This is so that the data is aligned to the
Decile range shown in the accompanying
heat map and radial graph.

16. Slideshow by Gavin Barker KEY SOURCES
www.gavin-barker.com
London Health Observatory
UCL Institute of Health Equity
YOU ARE FREE TO DOWNLOAD AND USE THIS
SLIDESHOW AS A TEMPLATE FOR YOUR OWN
LOCAL AREA
Should you do so, please delete my name and substitute the picture in slide
14. To embed a section of the map in your website, please contact me
gavinbark@gmail.com
Use the data for your local authority located at the London Health Observatory
This is available for upper tier local authorities in England only (excluding the City
of London and Isles of Scilly)