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Background to the work
[Background to the work] [The
HPI tool] [Variables and data sources] [Workplan]
[Who is on the HPI Project Team?] [Contact
us] [Useful links] [About
this site]
The NHS Plan (2000) states that "no injustice is greater than the inequalities
in health which scar our nation" and proposes a number of developments
to combat this situation. One of these is the production of a Health Poverty
Index (HPI). Following the publication of the NHS Plan, The Department of Health
(DoH) commissioned a scoping project to develop the HPI concept, involving
a major consultation and a series of discussions within the DoH and between
the DoH and other bodies charged with tackling the issue of health inequalities.
Work on the HPI development was being funded by the DoH and is
now funded by The Information Centre for health and social care.
It is being carried out by the Department of Geography and Geosciences,
University of St Andrews, the South East Public Health Observatory
(SEPHO), the
University
of Oxford, and Oxford Consultants for Social Inclusion (OCSI).
The HPI tool
The HPI tool allows groups, differentiated by geography and cultural identity,
to be contrasted in terms of their 'health poverty’. A group's 'health
poverty' is a combination of both its present state of health and its future
health potential or lack of it. The key justification for the selection of
a particular set of groups is the expectation of an equal distribution of health
and its determinants between the groups from the perspective of social justice.
A simple graphical representation of the conceptual framework lying behind
the design of the HPI is given below. It illustrates that the situation of
health, for a group, can be conceptualised as emerging from a history of
intervening factors that are themselves based in a set of root causes. Each
of these stages
is influenced by the different contexts in which they take place. These can
be seen as an immediate individual-household level, a local (intermediate)
level and a wider social (macro) scale.
In order to produce an index from the conceptual framework presented above,
it is necessary to identify and measure the important elements acting at different
points within the framework. It is argued that there are nine main ‘domains’ and
these are shown below. For each domain a set of indicators have been developed
which aim to capture the significant aspects of the domain as they exist for
different groups in society. These indicators are what are shown in the HPI
diagrams.
It should be emphasised that neither of the above diagrams are suppose to
be explanatory ‘models’. They simply aim to organise the elements
that have been proposed within the literature as important in the construction
of health inequalities into a form that will aid thinking about policies and
actions that might tackle these inequalities. The directions implied by arrows
in the diagrams simply stress a natural way of thinking about some of the potential
causal flows. They of course do not exemplify all of the complex ways in which
the different elements implicated in the production of inequalities interact.
The indicators collected have been scaled in such a way that high numbers
represent a situation of high health poverty. For the current tool the main
groups are Local Authority Districts (LAD) in England as they existed from
April 1st 2001 and ethnic minority groups in those districts. Each indicator
has been scaled in reference to scores across all the groups being compared
(i.e. all LADs in England). Thus, for each domain, a score of zero indicates
the best situation in terms of health poverty and a score of 1 the worst situation.
The data for each indicator has also been ranked, with the ranks then converted
to a scale from 0 to 1.
The data are presented in the following formats to allow comparison between
the chosen LAD area and the chosen reference group:
- Table of HPI scores for each indicator, chosen area and comparison group
- Bar chart - chosen area in red, comparison group in dark blue (a score
of zero indicates the best situation in terms of health poverty and a score
of 1 the worst situation)
- Spider diagram (referred to here as the HPI Chart) - chosen area in red,
comparison group in dark blue (a score of zero indicates the best situation
in terms of health poverty and a score of 1 the worst situation)
The data are presented in the scaled version by default, but it is also possible
to view the ranked version by choosing the ‘Show me ranked information’ option.
At present it is only possible to compare Local Authority Districts. The ability
to compare other groups will be implemented in Stage 3
of the project.
As well as being able to select individual LADs the tool also allows the
user to select standard comparative areas based on the ONS area classification
scheme listed below:
| ONS Classification of Local Authority Districts |
Super-groups
Cities and Services
London Suburbs
London Centre
London Cosmopolitan
Prospering UK
Coastal and Countryside
Mining and Manufacturing
Groups
Regional Centres
Centres with Industry
Thriving London Periphery
London Suburbs
London Centre
London Cosmopolitan
Prospering Smaller Towns
New and Growing Towns
Prosperous Southern England
Coastal and Countryside
Industrial Hinterlands
Manufacturing Towns
Sub-groups
Regional Centres A
Centres with Industry A
Centres with Industry B
Thriving London Periphery A
Thriving London Periphery B
London Suburbs A
London Suburbs B
London Centre A
London Centre B
London Cosmopolitan A
London Cosmopolitan B
Prospering Smaller Towns A
Prospering Smaller Towns B
Prospering Smaller Towns C
New and Growing Towns A
Prospering Southern England A
Coastal and Countryside A
Coastal and Countryside B
Coastal and Countryside C
Industrial Hinterlands A
Industrial Hinterlands B
Manufacturing Towns A
Manufacturing Towns B
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The ONS classification groups LADs that are similar in terms of their socio-economic
and demographic characteristics. An HPI score has been calculated for each
of these to allow comparisons.
Variables and data sources
The indicators used in the current visualisation tool come from a variety
of sources. For the full list and descriptions of the indicators, see the Indicators
page.
Workplan
It is envisaged that the HPI project will be completed in four stages as outlined
below:
| Stage of development |
Description |
Timescale |
| Stage 1 |
Demonstration website and HPI visualisation tool in place |
December 2002 |
| Stage 2 |
Data set populated with ‘real’ data at Local Authority District
area for the year 2001/02 |
Summer 2004 |
| Stage 3 |
Data available at sub-LA level and for subsections of the population
for the year 2001/03 |
2005 |
| Stage 4 |
HPI updates (the next data year will probably be 2005) |
2007 |
Who is on the HPI Project team?
At the University of St Andrews:
- Chris Dibben (Joint Project Leader)
- David Manley
At the Social Disadvantage Research Centre (SDRC), University of Oxford:
- Helen Barnes
- Maria Sigala
At the South East Public Health Observatory (SEPHO):
- Jo Watson (Joint Project Leader)
- Alison Hill
At Oxford Consultants for Social Inclusion (OCSI):
Contact us
We are always pleased to respond to any queries about our work. If you would
like any further information please contact us:
| Social Disadvantage Research Centre |
South East Public Health Observatory |
Dept of Social Policy and Social Work
University of Oxford
32 Wellington Square
Oxford
OX1 2ER
Tel: 01865 270 353
Fax: 01865 270 324
http://www.apsoc.ox.ac.uk/
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4150 Chancellor Court
Oxford Business Park South
Oxford
OX4 2JY
Tel: 01865 334714
Fax: 01865 334715
http://www.sepho.org.uk/ |
| University of St Andrews |
Oxford Consultants for Social Inclusion |
Dept of Geography and Geosciences
University of St Andrews
Irvine Building
North Street
St Andrews
KY16 9AL
Tel: 01334 462 894
Fax: 01334 463 949
http://www.st-andrews.ac.uk/
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15-17 Middle St
Brighton
BN1 1AL
Tel: 0870 240 1474
http://www.ocsi.co.uk |
Useful links to related websites & online
documents
About this site
The development and management of the website and database was carried
out by Oxford
Consultants for Social Inclusion. The website is based on the open source PHP, MySQL and jpgraph technologies.
An important consideration in the design of the tool, was the level of technology
available to users. Some users for example, would be using older PCs, running
a variety of software and possibly accessing the web via modems. It was important
that users in this kind of situation could still access the tool effectively.
The site was therefore designed to maximise access rather than to utilise
the latest functionality of web browers. Please send
feedback if you have any comments on the design and/or usability of the
site.
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