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Measuring our health: The Health Index 2020

Emma Rourke

As the ONS publish their Health Index 2020, Deputy National Statistician Emma Rourke explores its findings and explains how the data is already helping shape local health provision.

  • Communication and administration

This month (November) we have published our Health Index 2020 for England. The Health Index is a dataset that gives us a picture of the nation’s health and how this is getting better or worse. The Index tracks a broad range of factors which affect our health, from the air we breathe and our working conditions to obesity and mental health. The Index is divided into three categories:

  • Healthy People: covers health outcomes such as life expectancy, physical health conditions like dementia, cancer and kidney disease, disability, personal well-being and mental health.
  • Healthy Lives: covers health-related behaviours and personal circumstances including obesity, hypertension, drug misuse, smoking and cancer screening.
  • Healthy Places: covers the wider social, economic and environmental drivers of health such as crime, unemployment, child poverty, pollution, noise and road traffic.

Each aspect is given a ‘score’ indexed around 100 (which uses health in 2015 as a reference point). A score below 100 means that health is worse than England in 2015, a score above means health is better. Health scores can be seen at national, regional, local authority and integrated care system levels.

So, what do the data show?

Overall, health in England in 2020 declined (from 100.5 in 2019 to 100.1). Within this, the Healthy People score declined considerably compared to 2019. This was driven by higher death rates, declining mental health and greatly declining personal well-being. It wasn’t all bad news though: the Healthy Places score improved in 2020 driven by living condition factors, such as reductions in both air pollution and traffic accidents. Of course, when looking at these results, it’s important to consider them in the context of the early stages of the pandemic, a time when restrictions on activity such as unnecessary travel were severe compared to the levels of reduction attainable under normal conditions.

A Local Health Index

The Health Index has huge potential as a tool for local health care planning. We collaborated with Northumbria Healthcare NHS Foundation Trust to create a Local Health Index. This used our Health Index framework to explore the health challenges facing residents within the local authorities of Northumberland and North Tyneside. The Trust and their partners were then able to use this insight to plan ways to tackle inequalities in health. You can read more about Northumbria Healthcare NHS Foundation Trust’s Local Health Index project here.

What next?

The Health Index is a relatively new dataset, and we are continuing to improve it all the time. We are developing a projection tool to illustrate how changing one aspect of health within the Health Index might have an impact on other parts of health in the future.

We will publish data for the Health Index 2021 in the spring. This will help us to explore whether the changes in health we saw in 2020 have been temporary or lasting. Will we sustain some of the improvements we observed in levels of air pollution and road safety (among others) in 2020? Will those aspects of our health which declined in 2020 bounce back? We will have to wait for the next lot of data to shed light on these questions. In the meantime, I would encourage people to explore how health has changed their local area, using our interactive tool How health has changed in your local area: 2015 to 2020 – Office for National Statistics (