Health Inequalities Intervention Toolkit
This Health Inequalities Intervention Toolkit, developed jointly by the Association of Public Health Observatories and the Department of Health, focuses on improving life expectancy
and infant mortality rates, especially in disadvantaged areas. Based on local authority boundaries, it is designed to assist evidence-based local service planning and commissioning, including Joint Strategic
Needs Assessments. The Toolkit does this by providing information on the diseases, which are causing low life expectancy in individual areas, enabling good local priority setting.
The Toolkit was originally designed to support achievement of the national Public Service Agreement target to: "Reduce health inequalities by 10% by 2010 as measured by infant mortality and life
expectancy at birth." Although the PSA target has now ended, the Toolkit should still be useful to the NHS and local government, supporting planning to narrow inequalities in life expectancy and infant mortality
Life Expectancy Tools
There are separate life expectancy tools, one based solely on the former Spearhead areas, which were the focus of the life expectancy PSA target, and one for all local authorities in England.
Both tools are designed to support planning to help narrow local life expectancy gaps.
Spearhead Tool – Life Expectancy Gaps
The tool for former Spearhead areas was fully updated in April 2010 and made available for the first time as a web-based application within the intervention toolkit. The tool presents gaps in life expectancy between each former 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.
Spearhead Tool – Commissioning interventions
This part of the Spearhead tool was fully revised in 2010. 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 former 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 former 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 former Spearhead area, technical details underlying the tool, downloadable
data files, and links to further resources, can be accessed by clicking here
Spearhead Tools – 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
- 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, former 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
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 Public Health Observatories in England, working in partnership with the Department of Health.