Today the Office for National Statistics (ONS) has published the Health Index 2020 for England, which gives a rich insight into how the nation's health has changed.

These data allow users to take a deep dive into the aspects that affect the health of both individuals and communities, and to understand whether these might be getting better or worse. 

The Health Index is split into three categories (or domains), which describe health in its broadest terms: Healthy People, Healthy Lives and Healthy Places.

These domains can be further broken down to focus on health topics (or subdomains), such as mental health, and economic and working conditions. These subdomains consist of a set of specific measures such as obesity, alcohol misuse and air pollution.

Each aspect is given a score indexed around 100 (which uses health in 2015 as a reference point) and users can see health scores at national, regional, local authority and integrated care system levels. The data show how health has improved or declined over time, how this varies by area and what is driving this.

What the Health Index 2020 shows

  • Overall, the Health Index score for England in 2020 declined to 100.1 when compared with 100.5 in 2019; however, there was variation in the constituent domains.

  • The Healthy People score declined considerably in 2020 compared with 2019, from 99.6 to 95.4; this was driven by considerably worse personal well-being levels, higher mortality and worse mental health.

  • The Healthy Lives score declined in 2020, from 102.0 to 101.4; within this there was a varied picture, for example, there was a decrease in physical activity and an improvement in healthy eating.

  • Healthy Places improved in 2020, from 99.7 to 103.4; this was driven by reductions in crime and improvements in living conditions, a number of these changes were linked to the coronavirus (COVID-19) pandemic, for example, reductions in air pollution.

Emma Rourke, Interim Deputy National Statistician (Health, Population and Methods) at the ONS said:

"The index shows how health changed in 2020 during the early stages of the pandemic. We can see that there was an improvement in the Healthy Places domain due in part to factors such as better air quality, fewer road accidents and less crime impact. This was likely driven by the need for people to stay at home at this time. However, the score for the Healthy People category declined considerably, which reflects the impact the pandemic had on mental health and well-being.

"One of our key aims is for the Health Index to become a trusted tool for informing health strategy, in the same way GDP data informs understanding of the economy.

"Today's data enables decision makers to explore whether health trends are persistent, improving or deteriorating. We expect to publish the Health Index 2021 within the next six months and this will give us an even deeper understanding of health and health outcomes at national, regional and local level."

The ONS has also published an online article helping people to explore the Health Index for their locality. How health has changed in your local area features a tool enabling people to select an area and produce an automated report.

Commenting on today's Health Index release, Professor Chris Whitty, Chief Medical Officer for England, said:

"Data that allow us to track progress in improving health at national, regional and local levels are very important in improving health. By gathering information on health challenges we are better placed to respond to them. Then data allow us to see whether interventions have worked, and alter, end or extend them.

"We know there is a stark variation in health across the country when comparing different areas and more granular data will better equip health partners to work together to improve health for everybody, now and in the longer term.

"I strongly support efforts to provide more detail across a wide range of healthcare indicators."

Jim McManus, President of the Association of Directors of Public Health, said:

"The Health Index is an invaluable tool for directors of public health as it provides them with a unique overview of their local population's health. Not only can they use the stats it gives to compare and track the impact of their policies and programmes, but they are also able to really target their work and decide which health initiatives are needed where in order to improve people's health – allowing people to live longer, healthier lives."

The ONS has also collaborated with Northumbria Healthcare NHS Foundation Trust to develop a local Heath Index, which will be a valuable tool to gain more detailed insight into inequalities at a more local level and plan healthcare provision. It will also help the trust's Health Inequalities Programme board to explore the health challenges and other social and environmental factors that impact on health, which will allow them to shape and prioritise their health goals based on local needs.

As well as working with the ONS team, Northumbria Healthcare also worked with Northumberland County Council and North Tyneside Council to develop the local Health Index framework. As demonstrated in its development, the tool will further encourage collaborative working between healthcare and health-related organisations at a much more local level across the population.

Northumbria Healthcare NHS Foundation Trust's chief executive, Sir James Mackey, said:

"The development of the local Health Index is testament to the power of collaborative working. It also clearly demonstrates our trust's commitment to tackle health inequalities, continually improve the services and care we provide to our patients and improve the health and well-being of the local communities we serve.

 "Having the ability to understand in detail how and why health differs between different communities across our patch gives us very valuable and powerful insight allowing us to help improve peoples' lives and target healthcare interventions where they are most needed.

 "This information will allow health leaders, clinicians and other partners to have informed and real-time discussions about health. I would like to thank everyone involved in helping to develop the local index and look forward to further developing its use."

To learn more about the Northumbria Local Health Index project see Northumbria Local Health Index: Northumbria Healthcare NHS Foundation Trust.

Welcoming today's publication, Jonathan Pearson-Stuttard, Chair of the Royal Society for Public Health, said:

"Health drives prosperity nationally and locally. The ONS Health Index recognises health as an asset and enables tracking of composite health, rather than just illness, in order to see variations across the country in a more granular way. We know that health needs of the population vary substantially and the Health Index allows us to identify which areas, from health outcomes, risk factors to the wider determinants of health, have the largest contributions to inequalities. This framework could inform more targeted interventions to both improve the population's health and reduce inequalities in a timely and effective way."

Sarah Sweeney is Interim Chief Executive at National Voices, a coalition of over 200 health and care charities. Commenting on today's release, she said:

"We welcome the launch of the Health Index for England: 2015 to 2020. Our health is affected not only by the quality of care we can access, but also by the air we breathe, our income level, access to work opportunities and much more. We hope that the Index will help national and local government and our health systems, to think in a more joined up and holistic way about health, and to work in more upstream ways to prevent poor health and inequality."

The Health Foundation is an independent health and care charity, and Assistant Director Gwen Nightingale, said:

"The ONS Health Index is a practical tool that shines a spotlight on the many factors that influence health. Good health is one of the nation's primary assets, and the Index provides leaders with authoritative information to inform local plans to improve health.

"The Index also provides a common language to talk about health, and this is why we would like to see central government departments using the Health Index to describe progress and understand the local picture."

To read more about the Health Index and how this work will be developed, you can read our blog post The Health Index 2020 – measuring the nation’s health.


Note to editor

The estimates in the Health Index are experimental data and still under development. Data for 2020 are missing for some indicators because of the coronavirus (COVID-19) pandemic. This means some changes in 2020 may not be reflected. To read more about the methodology see the Health Index methods and development article. For further detail about the domains and indicators used in the Health Index see Health Index indicators and definitions.

Read the case study A blueprint for a Local Health Index (PDF, 838 kB) about our collaboration with Northumbria Healthcare NHS Foundation Trust where we used the Health Index tool to create a local experimental version, the Northumbria Local Health Index.

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