Policy Context for the Toolkit
To support Primary Care Trusts and local authorities, the Association of Public Health Observatories and Department of Health have developed the Health
Inequalities Intervention Toolkit. This is designed to assist evidence-based local service planning and commissioning, including Joint
Strategic Needs Assessments.
Health Inequalities National Target
The national health inequalities Public Service Agreement target is to: "Reduce health inequalities by 10% by 2010 as measured by infant mortality and life expectancy at birth."
This target is underpinned by two more detailed objectives:
- starting with children under one year, by 2010 to reduce by at least 10 per cent the gap in mortality between the routine and manual group and the population as a whole;
- starting with local authorities, by 2010 to reduce by at least 10 per cent the gap in life expectancy at birth between the fifth of areas with the worst health and deprivation (the Spearhead Group) and the population as a whole.
Tackling health inequalities and achieving the Public Service Agreement target remains a key priority for the NHS as set out in the NHS Operating Framework
2010-11, and for local authorities as part of Local Area Agreements.
The Spearhead Group provides a focus on those areas with, on average, the worst health, mortality and deprivation. However, health inequalities exist within all
areas, not just Spearheads and all areas have a role in tackling them.
The Tools
The toolkit contains tools to support planning to achieve both objectives within the national health inequalities target.
Life Expectancy Tools
There are currently separate tools for Spearhead areas only, and one for all local authorities in England. Besides supporting planning to help meet the national
health inequalities target, the tools can also be used to help meet targets set within Local Area Agreements, or as national priorities within the 2010 Operating
Framework, particularly the Vital Signs and LAA National Indicator Set indicator for reducing All Age All Cause Mortality.
Latest data Spearhead Tool – Life Expectancy Gaps
The tool for Spearhead areas has been updated and is available for the first time as a web-based application within the intervention toolkit. The tool presents
gaps in life expectancy between each Spearhead area and England as a whole, based on data for 2006-08. An improved set of tables and charts are available
which illustrate the causes of death, and age groups, which are making the greatest contributions to these gaps. To access the tool click the
Spearhead Tool – Life Expectancy Gaps button at the top of this page.
New Spearhead Tool – Commissioning interventions
This part of the Spearhead tool has been fully revised. To support commissioning decisions, it allows users to model the impact that systematically
implementing evidence-based interventions at scale can have on reducing inequalities in life expectancy and All Age All Cause Mortality between each Spearhead
area and England. A new intervention illustrates the gains in life expectancy which can be made by lowering levels of high blood sugar. This supplements the
original interventions (increasing numbers of smoking quitters, lowering infant mortality, and prescribing antihypertensives and statins) which have also been
updated within this latest version of the tool. To go to the intervention element of the tool: (1) Click the Spearhead Tool – Commissioning Interventions button at
the top of this screen, (2) Select the Spearhead area which you wish to model, (3) Click the Commissioning Interventions button.
A supplementary page with Frequently Asked Questions, pdf versions of the charts for each Spearhead area, technical details underlying the tool, downloadable
data files, and links to further resources, can be accessed by clicking here
Spearhead Tool – 2003-05 and 2005-07 data
Earlier versions of the Spearhead Tool remain available so that trends can be considered. The 2009 tool (based on data for 2005-07) and the 2007 tool
(based on data for 2003-05) can be found by clicking here
New Infant Mortality Tool
The Infant Mortality tool contains data for Strategic Health Authorities in England and for those local authorities with high numbers of infant deaths
in the Routine and Manual (R&M) group. For Strategic Health Authorities, the tool:
- Presents trends in infant death rates for the R&M group, births within marriage and joint registrations, and sole registrations.
- Shows the factors which are contributing to the gap in infant mortality between the R&M group and births within marriage and joint registrations
(such as such as smoking in pregnancy, poverty, maternal obesity and failure to initiate breastfeeding) and allows users to assess the impact of modifying these
factors.
- Brings together background data on factors which may influence infant mortality, such as deprivation, low birthweight and ethnicity.
Background data and charts of trends in infant mortality are also presented for those local authorities included within the tool. A link to further resources which may help address inequalities in infant mortality is also available.
To access the Infant Mortality Tool click the Infant Mortality Tool button at the top of this page. A web page with supplementary information, including
Frequently Asked Questions, the technical details underlying the tool, links to further resources, and downloadable data files, can be accessed
by clicking here
Health Inequalities Intervention Tool for All Areas
The existing Health Inequalities Intervention Tool for All Areas (2008) covers all local authorities in England, Spearhead and non-Spearhead, and provides
information on within, as well as between, area inequalities. The tool provides data on gaps in life expectancy between the most deprived quintile of each local
authority and a range of comparator areas, including an analysis of the causes of death which contribute most to these gaps.
The tool also allows local authorities to estimate the effect on their life expectancy if certain evidence based interventions are increased. To access the
tool click the Intervention Tool for All Areas button at the top of this page.
A supplementary page with instructions, Frequently Asked Questions and technical details underlying the tool can be found by clicking here
Your views
We welcome any queries or feedback on the toolkit. Let us know if anything is unclear, confusing or not functioning for you, by e-mailing us
The Health Inequalities Intervention Toolkit was developed by the Association of Public Health Observatories, working in partnership with the Department of Health.