The document summarizes health inequalities in East Sussex based on a landmark report by Professor Marmot. It finds significant variations in life expectancy, disability-free life expectancy, and social indicators based on area of deprivation. People in the most deprived areas have lower life expectancies, spend more years with disabilities, and face higher rates of unemployment, lower education achievement, and greater receipt of means-tested benefits. The report argues inequalities in income and wealth translate to inequalities in health outcomes, and that doing nothing to address social determinants of health will increase economic and healthcare costs.

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

3. In East Sussex the average life expectancy at birth is 79
years for men and 84 for women
83.5
South East
79.7
82.57
England
78.58
83.5
East Sussex
79.4
76 77 78 79 80 81 82 83 84
Years
Female Male
Data for years 2008 to 2010

4. But those living in the most deprived areas of East Sussexhave a lower
life expectancy compared to those in the more affluent areas
88
86
84
82 Data for years 2006
80 to 2010
YEARS
78
76 Male
74 Female
72
70
68
66
Decile Decile 9 Decile 8 Decile 7 Decile 6 Decile 5 Decile 4 Decile 3 Decile 2 Decile 1
10
Most deprived Decile range Least deprived
areas areas
8.2 The inequality in male life expectancy(years) in East Area based deprivation is often
Sussex 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 East residential segregation.
6.2
Sussex 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
8.2 11.4
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
6.2 expectancy (years) between
9.4 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
See the interactive map
below this presentation
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 certain
geographical areas.

7. Health inequalities result from social inequalities
88
86
84
82
80
YEARS
78
76
74
72
70
68
66
Decile 10 Decile 9 Decile 8 Decile 7 Decile 6 Decile 5 Decile 4 Decile 3 Decile 2 Decile 1
Male Female
Social inequality indicators used to predict health outcomes
The London Health Children
Observatory (LHO) Young people People in receipt
achieving a not in Means tested
and the UCL Institute good level of of means tested
employment, edu benefits by area
of Health Equity have development benefits
cation or training of deprivation
produced the following aged 5
key indicators relating
to the social
determinants of health
outcomes

8. In East Sussex only 52% of children achieved a good level of
development at age 5 (Year 2011)
The highest priority in the Marmot Review is
58.2
South East the aim to give every child the best start in
61.1
life, as this is crucial to reducing health
inequalities across the life course.
55.7
England As the foundations of human development are laid in
58.8 early childhood, the review proposed an indicator of
readiness for school to capture early years
55.6 development.
East Sussex
51.9
The percentage of children achieving a good level of
development is presented for this indicator, based on
46 48 50 52 54 56 58 60 62
the local authority where each child was living, rather
Percentges % than the location of the school. As LAs are only
required to report results for the schools and
Early years % yr 2010 Early years % yr 2011 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.
Children Young people
indicators used achieving a People in receipt Means tested
not in of means tested
to predict health good level of employment, edu benefits by area
development benefits
outcomes cation or training of deprivation
aged 5

9. In East Sussex 6.9 % of young people are not in
employment, education or training (NEETs)
Nov 2009 to Jan2010 Nov 2010 - Jan2011 Non-participation of young people in
education, employment or training between the
South East
6.3 ages of 16 and 19 is a major predictor of later
6.1 unemployment, low
income, depression, involvement in crime and
7
England poorwas recognised in the Marmot Review which
This mental health
6.7
proposed an indicator to measure young people not in
7.8 education, employment or training in order to capture skill
East Sussex development during the school years and the control that
6.9
school leavers have over their lives. This indicator is
0 2 4 6 8 10 therefore a wider measure than just youth unemployment
as it also includes young people who are not being
Percentages %
prepared for work
Children Young people
achieving a People in receipt Means tested
indicators used not in of means tested
good level of benefits by area
to predict health employment, edu benefits
development cation or training of deprivation
outcomes aged 5

10. In East Sussex, 12.8% of people were in receipt of means
tested benefits (Year 2008)
Yr 2005 Yr 2008
The importance of reducing income
10.6
South East inequality, and the negative consequences of
10.1
relative poverty, was emphasised in the Marmot
Review, which noted that: “An adequate and fair
15.5
England healthy standard of living is critical to reducing
14.6
health inequalities. Insufficient income is
associated with worse outcomes across virtually
13.2
East Sussex all domains, including long-term health and life
12.8
expectancy.”
0 5 10 15 20
Percentages %
Children Young people
achieving a People in receipt Means tested
indicators used not in of means tested
good level of benefits by area
to predict health employment, edu benefits
development cation or training of deprivation
outcomes aged 5

11. The figure for means tested benefits (12.8 %) broken down by
area of deprivation
35
For example those areas falling into
30
the bottom decile (decile 10) have a
far higher concentration of their
25 population on benefits (around
32%) compared to decile 1 (around
20 5%)
Benefits yr 2008)
15
Benefits yr 2005
10
5
0
Decile Decile Decile Decile Decile Decile Decile Decile Decile Decile
10 9 8 7 6 5 4 3 2 1
Children Young people
achieving a People in receipt Means tested
indicators used not in of means tested
good level of benefits by area
to predict health employment, edu benefits
development cation or training of deprivation
outcomes aged 5

12. 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 Children Young people
achieving a People in receipt Means tested
Health Equity have not in
good level of of means tested benefits by area
produced the following employment, edu
development benefits of deprivation
key indicators relating to cation or training
the social determinants aged 5
of health outcomes

13. 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

14. Slideshow by Gavin Barker
KEY SOURCES
London Health Observatory
UCL Institute of Health Equity