What role for place in enabling healthy lives?

13 June 2018

By CPP

Life expectancy at birth is six years longer in England’s least deprived local authority – Hart, a district in London’s commuter belt – than in its most deprived local authority – City of Hull, a traditional port town.

These geographical patterns tell us that health is as much an issue – if not more so – of place and populations as it is about access to hospital care and complex medical technologies. Studies have shown that medical care – all kinds – accounts for as little as 10% of a population’s health outcomes, with the rest accounted for by behaviours, social circumstances, environment, and genetics.

The new Centre for Progressive Policy (CPP) report, Diagnosis Critical: launching an inquiry into health and social care, shows that deprivation, measured across income, employment, education, housing and crime, can explain almost half of the variation in male life expectancy at birth at the local authority level.


The link between income and employment deprivation and health care is particularly strong and explains why health outcomes in England are spatially correlated. Further CPP analysis of 32,844 local super output areas (LSOAs) in England show that the spatial distribution of income deprivation across England can explain 47% of potential life years lost, the average years a person would have lived had they not died prematurely. Employment deprivation can explain up to 49% of years of potential life lost.

The link also exists for mental, and not just physical, health. England’s spatial distribution of income deprivation can explain up to 37% of the country’s distribution of mood and anxiety disorders, measured by the prevalence of mood (affective), neurotic, stress related and somatoform disorders. Employment deprivation can explain up to 52% of these disorders.

As deprivation plays a major role in explaining local health outcomes, it therefore exerts strain on local health care services. CPP analysis of the same LSOA data shows that areas with high levels of deprivation have significantly higher levels of unplanned admissions to hospital. Employment deprivation alone can explain 61% of the variation in unplanned admissions to hospital.

CPP’s analysis shows the most powerful policy levers potentially lie outside health care and relate to wider social and economic issues, including employment, income, education, housing, air quality, crime and public safety.

CPP’s inquiry into health and social care in England will present evidence as to how the NHS, under present demographic trends and geographical patterns of deprivation, can tackle the broader social and economic determinants of health and improve output across the whole country learning from global top performers.

The imaged used above is by hamiltonpaviana, published under CC0