This tool has been developed to present evidence of inequalities in health within England. It is based on PHE’s Health Equity Dashboard, which contains key indicators being used by PHE to monitor progress on reducing inequalities. All indicators are drawn from the Public Health Outcomes Framework and are divided into the following domains:
In this initial version of the tool, inequalities are presented only within England as a whole. In future versions of the tool, inequalities within sub-national areas will be added, where data are available.
The overview tab provides a summary table for all the indicators in the dashboard and the associated inequality measures. Data are displayed for a baseline period (date nearest to PHE inception) and a reporting period (the latest available data), with an indication of change between periods and direction of the trend.
The data tab provides visualisations of the trends over time for indicators and the summary inequality measure where available. It also shows the trend for indicators by inequality group. The table shows the underlying data and confidence intervals at a 95% level.
The definitions tab provides supporting information for each indicator.
The SII is a measure of inequality. The SII is a measure of the social gradient in an indicator and shows how much the indicator varies with deprivation (by deprivation decile). It takes account of inequalities across the whole range of deprivation within England and summarises this into a single number. The measure assumes a linear relationship between the indicator and deprivation. The SII represents the absolute difference in the indicator across the social gradient from most to least deprived.
The RII is a summary measure of inequality related to the Slope Index of Inequality. While the SII measures the absolute difference between the most and least deprived, the RII measures the relative difference. For example, the RII for the under 75 mortality rate from cancer in England is 2.2. This means that the rate for the most deprived is 2.2 times higher than the rate for the least deprived.
For three indicators (infant mortality, admissions for alcohol-related conditions, and under 75 mortality rate for cardiovascular disease) their relationship with deprivation is not linear. For this reason an SII measure is not currently presented within the tool. An RII value is presented for these indicators using an adapted form of this measure, calculated by first log transforming the deprivation decile values and then calculating the RII based on these.
The absolute gap measures the absolute difference between two groups. This may be between a specific population group and the national average, or between two independent population groups. The relative gap is the proportional difference between the two groups.
This is a measure of inequality. Where the dimension of inequality being considered contains a number of population groups which cannot be logically ordered, such as indicators by ethnic group, a summary measure called the mean deviation has been presented. The measure shows the average of the absolute differences between each of the groups and a reference group. Values are treated as positive whether they are higher or lower than the reference group. The largest group is selected as the reference group for each indicator.
The Index of Multiple Deprivation (IMD) is a measure of relative deprivation for small areas. It is one element of the English Indices of Deprivation released by the Ministry of Housing, Communities and Local Government.
Further detail on these measures can be found in Appendix 2 of the PHOF Health Equity Report.
This tool has been developed by PHE’s Epidemiology and Surveillance Team, part of PHE’s Health Intelligence division. If you have any questions about the tool, or feedback (including suggestions for future developments) please contact us at: