Marmot Principles and neighbourhood level data

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The Marmot Review, published back in 2010, still has important implications today for evidence-based approaches to addressing health inequity. Here, we explore data that is regularly updated, available at small area level and can be aligned to each of the six Marmot Principles. All of the indicators are available in Local Insight – our place-based data platform that brings together more than 1000 small-area indicators ready to explore for any area through maps, reports and dashboards.

What is The Marmot Review?

The Marmot Review was an independent study, commissioned by the government, to explore the most effective evidence-based strategies for reducing health inequalities in England from 2010. 

The final report, “Fair Society, Healthy Lives”, was published in February 2010 and found that many people were dying prematurely due to health inequalities. It found that these health inequalities resulted from social inequalities, and that the lower a person’s social position, the worse his or her health.  In total, between 1.3 and 2.5 million extra years of life were lost due to these inequalities.

Focusing on solely the most disadvantaged areas is not enough to reduce health inequalities sufficiently – but while actions must be universal, this should be proportionate to the level of disadvantage (which is where access to reliable small-area data comes in useful).

The Marmot Review argues that reducing health inequalities will require action on six principles to address the social determinants of health – and that the successful delivery of these objectives will depend on action from a range of both national and local stakeholders. These include central and local government, the NHS, third and private sectors as well as community groups.

What are social determinants of health?

Social determinants of health are the non medical factors that ultimately influence health outcomes – either positively or negatively.

They are the conditions and systems that shape the context of daily life and can refer to the social, cultural, political, economic, commercial and environmental factors we operate in. 

Examples of social determinants of health include:

  • Safe housing and neighbourhoods
  • Education, job opportunities and household income
  • Access to healthy food and opportunities for physical activity
  • Levels of air and water pollution

What is a Marmot Place?

A Marmot Place (such as Coventry) recognises that health inequalities are largely shaped by the social determinants of health and they take action to reduce health inequalities. 

Based on the Marmot Principles, Marmot Places develop and deliver interventions to improve health equity through a long-term, whole system approach. 

Principle 1: Give every child the best start in life

In order to “give every child the best start in life” the Marmot Review suggests we need to:

  • Reduce inequalities in the early development of physical and emotional health, and cognitive, linguistic and social skills.
  • Ensure high quality maternity services, parenting programmes , childcare and early years education
  • Build the resilience and wellbeing of young children. 

The following indicators, available at small-area level can help identify the most disadvantaged areas. Dates are correct as of 05/07/2024.

Indicators for Principle 1: Give every child the best start in life
Name Source Date Update frequency
Deaths under 28 days (neonatal mortality), all causes Nomis 2018 – 2022 Annual
Deaths under 1 (infant mortality), all causes Nomis 2018 – 2022 Annual
Children in relative and absolute low-income families (various breakdowns) Department for Work and Pensions (DWP) 2023 Quarterly
Households on Universal Credit, Disabled Child Entitlement Department for Work and Pensions (DWP) February 2024 Quarterly
Children providing unpaid care Census 2021 2021 Every ten years

 

Principle 2: Enable all to maximise capabilities and control their lives

In order to “enable all to maximise capabilities and control their lives, the Marmot Review suggests we need to:

  • Reduce the social gradient in skills and qualifications
  • Ensure that schools, families and communities work in partnership to reduce the gradient in health, wellbeing and resilience of children
  • Improve the access and use of quality life-long learning across the social gradient. 

The following indicators, available at small-area level can help identify the most disadvantaged areas. Dates are correct as of 05/07/2024.

Indicators for Principle 2: Enable all to maximise capabilities and control their lives
Name Source Date Update frequency
Highest level of qualification (various indicators including Level 1 – 4 and apprenticeships) Census 2021 2021 Every 10 years
Participation in higher education (Proportion of a young cohort that has entered higher education by age 19) Office for Students 2010 – 2015 Irregular
Participation of state school pupils in higher education Office for Students 2019 – 2020 Annual
Indices of Deprivation:  Education, Skills and Training Rank Ministry of Housing Communities and Local Government (MHCLG) 2019 Irregular (next update due 2025)

 

Principle 3: Create fair employment and good work for all

In order to “create fair employment and good work for all” the Marmot Review suggests we need to: 

  • Improve access to good jobs and reduce long term unemployment
  • Make it easier for people who are disadvantaged in the labour market to obtain and keep work
  • Improve quality of jobs

The following indicators, available at small-area level can help identify the most disadvantaged areas. Dates are correct as of 05/07/2024.

Indicators for Principle 3: Create fair employment and good work for all
Name Source Date Update frequency
Jobseekers Allowance claimants, claiming for over 12 months Department for Work and Pensions (DWP) May 2024 Monthly
Unemployment benefit claimants (JSA and Universal Credit) – including breakdowns by gender Department for Work and Pensions (DWP) May 2024 Monthly
Youth unemployment (18-24 receiving JSA or Universal Credit) Department for Work and Pensions (DWP) May 2024 Monthly
Older person unemployment (50+ receiving JSA or Universal Credit) Department for Work and Pensions (DWP) May 2024 Monthly
Job access score UK Onward 2021 Irregular
Indices of Deprivation 2019 – Employment Score Ministry of Housing Communities and Local Government (MHCLG) 2015 – 2016 Irregular (next update due in 2025)

 

Principle 4: Ensure a healthy standard of living for all

In order to “ensure a healthy standard of living for all”, the Marmot Review suggests we need to:

  • Establish a minimum income for healthy living for people of all ages
  • Reduce the social gradient in the standard of living through progressive taxation and other fiscal policies
  • Reduce the cliff edges faced by people moving between benefits and work. 

The following indicators, available at small-area level can help identify the most disadvantaged areas. Dates are correct as of 05/07/2024.

Indicators for Principle 4: Ensure a healthy standard of living for all
Name Source Date Update frequency
Households in Fuel Poverty Department for Business, Energy & Industrial Strategy (BEIS) 2022 Annual
Priority Places for Food Index (Rank) Consumer Data Research Centre (CDRC) 2023 Irregular
Overcrowded housing (with occupancy rating of -1 or less) Census 2021 2021 Every 10 years
Houses lacking central heating Census 2021 2021 Every 10 years
Indices of Deprivation 2019 – Income Score Ministry of Housing Communities and Local Government (MHCLG) 2019 Irregular (next update due 2025)

 

Principle 5: Create and develop healthy and sustainable places and communities

In order to “create and develop healthy and sustainable places and communities”, the Marmot Review suggests we need to:

  • Develop common policies to reduce the scale and impact of climate change and health inequalities
  • Improve community capital and reduce social isolation across the social gradient

The following indicators, available at small-area level can help identify the most disadvantaged areas. Dates are correct as of 05/07/2024.

Indicators for Principle 5: Create and develop healthy and sustainable places and communities
Name Source Date Update frequency
Access to Healthy Assets and Hazards – various indicators Consumer Data Research Centre (CDRC) 2022 Irregular
Community Needs Index and its sub domains OCSI / Local Trust 2023 Irregular
Travel time to key services (various indicators) Department for Transport (DfT) 2019 Irregular
Digital Exclusion Risk Index Greater Manchester Office of Data Analytics 2021 Irregular
Broadband speed Ofcom May 2023 Irregular

 

Principle 6: Strengthen the role and impact of ill-health prevention

In order to “strengthen the role and impact of ill-health prevention, the Marmot Review suggests we need to: 

  • Prioritise prevention and early detection of those conditions most strongly related to health inequalities
  • Increase availability of long-term and sustainable funding in ill health prevention across the social gradient. 

The following indicators, available at small-area level can help identify the most disadvantaged areas. Dates are correct as of 05/07/2024.

Indicators for Principle 6: Strengthen the role and impact of ill-health prevention
Name Source Date Update frequency
Obese children in reception year National Child Measurement Programme, NHS Digital 2019 – 2022 Irregular
Obese children in year 6 National Child Measurement Programme, NHS Digital 2019 – 2022 Irregular
Disease prevalence (Including obesity, cardiovascular disease, asthma, diabetes – 20 total) NHS Digital via House of Commons Library 2022/2023 Irregular
Life expectancy at birth Office for Health Improvement and Disparities (OHID) 2016 – 2020 Irregular
Indices of Deprivation 2019 –  Health Deprivation and Disability Rank Ministry of Housing Communities and Local Government (MHCLG) 2019 Irregular (next update due 2025)
Bad / Very Bad health Census 2021 2021 Every 10 years
Deaths from key causes Office for National Statistics (ONS) 2016 – 2019 Irregular
Adults who are physically active / inactive Sport England: Active Lives Survey 2021 Irregular
Participation in physical activity at least twice in the last month Sport England: Active Lives Survey 2021 Irregular

 

Where can I access this data?

The indicators outlined here are generally available as open data via the source highlighted. However, it can be time consuming to find, clean and process this data in order to gain the insights you are looking for.

This is where Local Insight comes in. Local Insight brings together all of these indicators (plus 1000 more) under one roof. All indicators are instantly aggregated to the areas you care about and can be explored through maps, reports and dashboards.

Local Insight will save you time and resources – and will free up your time to do the more interesting things, like analysing the data.

Book a free demo now. 

 


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