Deprivation is more than just a poverty of income. Deprivation can be a lack of access to adequate education, skills and training, healthcare, housing and essential services. It may also mean exposure to higher rates of crime, a poor environment and many other negative factors.
The social circumstances of the area in which you live have a massive impact on your life chances and ultimately your health and wellbeing. Men living in the most deprived communities of England can expect to die, on average, ten years sooner than their counterparts living in the least deprived communities. (PHOF male life expectancy at birth 2012-14)
As highlighted by the Marmot review “Inequalities in health arise due to inequalities in society – in the conditions in which people are born, grow, love, work and age” and so in order to reduce inequalities in health tackling these wider social determinants are key.
There are a number of different approaches to trying to measure deprivation in a community. The Index of Multiple Deprivation, commonly known as the IMD, is the official measure of relative deprivation for small areas in England. It is the most widely used of the Indices of Deprivation and ranks every small area in England from 1 (most deprived area) to 32,844 (least deprived area). These small areas are Lower-layer Super Output Areas.
The Index of Multiple Deprivation (IMD) combines information from seven domains to produce an overall relative measure of deprivation. Domains include: income deprivation, employment deprivation , education, skills and training, death and disability, barriers to housing and services, and quality of living environment.
In terms of deprivation, Slough is ranked 78th out of 152 upper-tier unitary authorities in England, where a ranking of 1 is the most deprived (based on the 2015 Indices of Multiple Deprivation average score). Within the South East Slough ranks as the 5th most deprived local authority, above all five other authorities in Berkshire.
This is an improvement compared with IMD scores in 2010 which placed Slough as the 69th most deprived of 152 authorities in England (based on 2015 IMD average score).
The map below (Figure 1) shows the relative levels of deprivation compared to the country as a whole in different areas of the Slough borough. Areas shaded blue are more deprived than those shaded yellow. Maps of deprivation can be explored via an online interactive tool (http://dclgapps.communities.gov.uk/imd/idmap.html).
As well as average score, changes in IMD can be viewed in terms of the number of LSOAs (lower super output areas) within the local authority that fall into each decile (tenth) of deprivation in England from the most deprived 10% to the least deprived 10%.
In 2015 there were no LSOAs in Slough that fell in the category of the most deprived 10% in the country, as opposed to one LSOA in 2010. Similarly, while there were no LSOAs in the 9th and 10th deciles (the least deprived 20% in the country), one LSOA now falls within this category (Table 1).
In addition to the overall index, there are sub-indices that highlight particular facets of deprivation. Two of particular interest are the income deprivation affecting children index (IDACI) which measures the proportion of children living in low income households, and the income deprivation affecting older people (IDAOPI) which measures the proportion of people aged over 60 living in low income. Low income is defined as receiving benefits and/or earning less than 60% of average incomes.
In 2015, the proportion of children living in income deprivation was 19% this is a reduction on the 2010 value. In terms of older people living in income deprivation in 2015 the figure was found to be 24%, this is an increase on the 2010 value.
There has been a small but encouraging improvement in deprivation levels in Slough over the last 5 years. Despite this, there remain a number of neighbourhoods in Slough that are among the most deprived in England, and in order to improve the health of the population, and reduce the resulting health inequalities there must be continued efforts both to reduce levels of and effects of deprivation on health and wellbeing.
The Marmot Review (2010) report Fair Society Healthy Lives outlines the importance of reducing health inequalities in the population. The Marmot Review Informed the Public Health Strategy “Healthy Lives, Healthy People” published the subsequent year.
Healthy Lives, Healthy People: our strategy for public health in England (2011) in setting out the Public Health Outcomes Framework (PHOF) identifies ‘Wider determinants of ill health’ as a key domain with deprivation inequality a key performance indicator for public health activities.
Inequality in healthy lives is highlighted as a key challenge and opportunity in Slough’s Five Year Plan. Reducing health inequalities I also highlighted as a key priority in the Slough Joint Wellbeing Strategy.
The effect of deprivation on health needs to be considered in all local strategies