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Deprivation, Poverty and Public Health
Lucy Macleod, Interim Director of Public Health
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2www.equalitytrust.org.ukWilkinson & Pickett, The Spirit Level
Life expectancy in rich countries is no longer related to National Income per head
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Local Neighbourhoods(in England & Wales)
Life
exp
ecta
ncy
(yea
rs)
Richest Poorest
Wilkinson & Pickett, The Spirit Level www.equalitytrust.org.uk
Life expectancy is strongly related to income within rich countries
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3.7 3.9 4.3 4.6 4.8 5.2 5.3 5.6 5.6 5.6 5.7 6.1 6.26.7 6.8 6.8 7.2
8.5
9.7
4.0
8.07.0
3.4
Income gapsHow many times richer are the richest fifth than the poorest fifth?
Wilkinson & Pickett, The Spirit Level www.equalitytrust.org.uk
Inequality...How much richer are the richest 20% in each country than the poorest 20%?
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5www.equalitytrust.org.ukWilkinson & Pickett, The Spirit Level
Neither health nor social problems are related to national income per head
Index of: • Life expectancy• Math & Literacy
• Infant mortality• Homicides• Imprisonment• Teenage births • Trust• Obesity• Mental illness
– incl. drug & alcohol addiction
• Social mobility
Index of health and social problems
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6Wilkinson & Pickett, The Spirit Level
Index of: • Life expectancy• Math & Literacy
• Infant mortality• Homicides• Imprisonment• Teenage births • Trust• Obesity• Mental illness
– incl. drug & alcohol addiction
• Social mobility
www.equalitytrust.org.uk
Health and social problems are worse in more unequal countries
Index of health and social problems
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7www.equalitytrust.org.ukWilkinson & Pickett, The Spirit Level
The UNICEF Index of Child Wellbeing is not related to National Income per head
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8www.equalitytrust.org.ukWilkinson & Pickett, The Spirit Level
Child well-being is better in more equal countries
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9www.equalitytrust.org.ukWilkinson & Pickett, The Spirit Level
Mental illness is more common in more unequal societies
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10www.equalitytrust.org.ukWilkinson & Pickett, The Spirit Level
Imprisonment rates are higher in more unequal countries
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Impacts of Poverty• Restriction of choice• Disempowerment• Dignity and self respect• Marginalisation• Stigma• Biological
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Outcomes of Poverty• Poorer general health• Poorer mental health• Earlier disability• Earlier death• Health and wellbeing burden to
individuals and families• Treatment and cost burden to society
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Norfolk at Present• About 11% of the population are in the most deprived
group in England
• Child poverty significantly higher than the national average for Norwich and Great Yarmouth.
• Great Yarmouth has the highest inequality in child poverty across Norfolk and Waveney (6.5% - 49%)
• Over a quarter of households in North Norfolk are estimated to be fuel poor.
• Fuel poverty ranges from over 40% of households for an area in West Norfolk to about 10% for an area in Broadland.
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Long Term Unemployment in Norfolk
Long Term Unemployment December 2010 Dec 2011
Local Worst
Local Best
Breckland 10.6 1.5 Broadland 245 3.5 7.4 5.4 1.6 Great Yarmouth 655 11.7 7.4 35.0 2.7 King's Lynn and West Norfolk 490 6.2 7.4 16.4 1.4 North Norfolk 265 5.1 7.4 8.3 2.7 Norwich 995 10.0 7.4 17.9 2.5 South Norfolk 250 3.6 7.4 6.4 0.9 Waveney 470 7.2 7.4 25.3 2.0 Norfolk 3,270 6.5 7.4 35.0 0.9
England Average 7.4 Claimant count (rounded to the nearest 5) for Jobseekers Allowance, working age claiming for more than 12 months, crude rate per 1000 resident working age population. Working age is defined as females aged 16 to 59 and males aged 16 to 64. Source: NOMIS
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Male Disability Free Life Expectancy in
NorfolkMale Disability Free Life Expectancy at Birth 1999 to 2003
Local Worst Norfolk and Waveney Range
Local Best
Breckland 59.1 65.9Broadland 62.8 68.0Great Yarmouth 50.2 64.5King's Lynn and West Norfolk
52.7 66.6
North Norfolk 59.5 66.5Norwich 53.6 67.1South Norfolk 64.1 68.0Waveney 54.9 65.4Norfolk 50.2 68.0
England Av 61.7
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Other MeasuresMeasure Norfolk Best Norfolk Worst England
AverageMale Life Expectancy #
83.7 71.3 78.6
Female Life Expectancy #
90.4 77.5 82.6
Male Deaths under 75 *
151.5 695.4 345.5
Female Deaths under 75*
97.8 428.1 219.5
• * 2008-10 DSR• # 2008-10
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Mitigation• Equitable Provision• Better access to support• Coping strategies – reaffirmation of
humanity, empowerment, control• Improved default • Measuring, monitoring, engaging,
advocacy