Official Statistics

Wider Determinants of Health: statistical commentary, February 2022 update

Published 1 February 2022

Applies to England

New in this update

We have added new data to the following indicators:

• air pollution (fine particulate matter)
• homelessness:
  • all households owed a duty under the Homelessness Reduction Act
  • households with dependent children owed a duty
  • households owed a duty (main applicant 16 to 24 years)
  • households owed a duty (main applicant 55+ years)
  • households in temporary accommodation
• proportion of adults with a learning disability who live in stable and appropriate accommodation
• proportion of adults in contact with secondary mental health services who live in stable and appropriate accommodation
• average weekly earnings
• gender pay equality
• percentage of employees who had at least one day off in the previous week
• percentage of working days lost due to sickness absence
• rate of work-related illness
• rate of workplace injury

Several indicators in other Fingertips profiles have been updated with new data also included in this Wider Determinants release. These are covered in the relevant statistical commentary – for example, for the Public Health Outcomes Framework.

Summary of new and updated indicators

This summary focuses on England-level data. The Wider Determinants of Health profile presents indicators primarily at the local authority level in addition to regional and England values. Most of the data in this update is from 2020 onwards and has been markedly impacted by the coronavirus (COVID-19) pandemic. Many of the indicators based on data for 2020 and 2021 need to be interpreted with caution, given the impact of the pandemic which affected many aspects of behaviour, particularly in relation to employment. Policies put in place to mitigate the impact of the pandemic, and the additional pressures placed on local authorities, will also have influenced some indicators.

This summary presents key results from the update and provides some contextual information to help interpret the latest data.

Air pollution

There has been a pronounced decline from 2019 to 2020 in the population-weighted concentrations of particulate matters (PM2.5) representing air quality in a location. This fall was observed across all regions across England and in 2020 was the lowest recorded since 2011 in every region. The highest values of PM2.5 continue to be in London.

Homelessness

Five homelessness indicators have been updated with 2020 to 2021 data: households owed a duty under the Homelessness Reduction Act, and by age of main applicant (55 and over, 16 to 24), those with dependent children, as well as households in temporary accommodation. Government and local authority responses to COVID-19 have affected the statistics for 2020 to 2021.

The overall number of households owed a duty in England was lower at 268,560 households in 2020 to 2021, compared with 288,470 households in 2019 to 2020.

Homelessness is presented in the profile as a combined indicator for households owed a prevention duty (for those threatened with homelessness) and households owed a relief duty (for those already homeless).

The coronavirus pandemic had significant implications for households’ ability to retain their homes, particularly those who are renting. In response, governments across the UK introduced a series of housing support measures to prevent evictions during the pandemic. The number of households owed a prevention duty was consequently around one-fifth lower in 2020 to 2021 than the year before.

Although this fall in households owed a prevention duty resulted in an overall improvement in the homelessness indicator in 2020 to 2021, the number of households owed a relief duty was 6% higher than in 2019 to 2020. Much of this rise was due to the ‘Everyone In’ programme: local authorities were asked to provide emergency accommodation to rough sleepers, people who were living in shelters with shared sleeping arrangements, and those at risk of rough sleeping.

The majority of households owed a homelessness relief duty were single adults (without children); this group was the primary driver behind the increase in cases.

The number of households with dependent children owed a duty fell from 97,180 in 2019 to 2020 to 75,120 in 2020 to 2021. The number of households owed a duty where the main applicant was aged 16 to 24 increased from 60,850 in 2019 to 2020 to 61,460 in 2020 to 2021. Where the main applicant was aged 55 and over, the number fell from 30,540 in 2019 to 2020 to 24,580 in 2020 to 2021.

Households in temporary accommodation also went up due to the ‘Everyone In’ campaign and remain particularly high in London compared with the rest of England. There were 88,533 households in temporary accommodation in 2019 to 2020, increasing to 95,400 in 2020 to 2021.

Detail on trends in statutory homelessness and the impact of the pandemic on 2020 to 2021 statistics can be found in a UK Parliament research briefing.

Adults in contact with social care services and living independently

The adult social care indicators measure how well care and support services achieve the outcomes that matter most to people. There has been significant pressure on adult social care services during the pandemic, for example more appointments were carried out via phone/telemedicine/email. Therefore, data should be interpreted with care over the pandemic period.

The proportion of adults in England in contact with secondary mental health services living independently, with or without support, was 58% in 2020 to 2021. This proportion has remained stable over recent years. The North East has the highest proportion (69%) of adults in contact with secondary mental health services living in their own home or with family. West Midlands has the lowest (48%).

The proportion of people in England with a learning disability living in their own home or with family was 78% in 2020 to 2021. There has been a continued upward trend in this indicator. The North West has the highest proportion (87%) of people with a learning disability living in their own home or with family, West Midlands the lowest (71%).

A report on the main findings for measures from the England Adult Social Care Outcomes Framework for the financial year 2020 to 2021 can be found on the NHS Digital website.

Average weekly earnings

There was an increase in the average weekly earnings in England between 2020 and 2021 from £474.40 to £496.00. This increase was observed across all regions in England except the North East, where there was no significant change between 2020 and 2021. However, this indicator has also been impacted by the pandemic as many workers have been on furlough or had their hours reduced.

A blog from the Office for National Statistics (ONS) provides a guide on how to interpret the average earnings data during the time of the pandemic.

Gender pay equality

Gender pay equality in 2020 was 84.0%. For this indicator, the closer the value is to 100, the greater the equality. This has been increasing from 79.4% in 2015.

Evidence from the Annual Survey of Hours and Earnings (ASHE) and the Labour Force Survey (LFS) suggests that COVID-19 factors did not have a notable impact on gender pay in 2020. Commentary on data from the Annual Survey of Hours and Earnings (ASHE) and the impact of the pandemic can be found on the Office for National Statistics (ONS) website.

Sickness absence

In 2020 to 2021, 1.9% of employees in England had at least one day off in the previous working week, a significant fall from 2.1% the year before.

In 2020 to 2021, the percentage of working days lost to sickness was 1.1%, not significantly different from 1.0% in the year before.

The pandemic has affected the sickness absence data in a number of ways: while the virus may have led to additional sickness absence, measures such as furloughing, social distancing, shielding and increased homeworking appear to have helped reduce other causes of absence, allowing the general downward trend to continue. Commentary on measuring sickness absence during the pandemic is provided by the Office for National Statistics (ONS).

Work-related illness

Since the 3-year period between 2014 to 2015 and 2016 to 2017, England and all its regions have shown a general increase in work-related illness. The main causes of work-related illness are stress, depression or anxiety, musculoskeletal disorders as well as exposure to COVID-19 at work.

Despite the COVID-19 pandemic, estimates of the rate of self-reported work-related ill health in 2020 to 2021 are broadly comparable, methodologically speaking, with estimates from earlier years. A technical report published by the Health and Safety Executive (HSE) (PDF, 787KB) describes the impact of the pandemic on the interpretation of Health and Safety Statistics in the financial year 2020 to 2021.

Workplace Injuries

Prior to the pandemic, the rate of self-reported non-fatal injury to workers showed a generally downward trend. In the most recent 3-year period, 2018 to 2019 to 2020 to 2021, the rate was lower than in previous data periods although the at-risk population was not adjusted for people on furlough.

Preliminary work by the Health and Safety Executive (HSE) confirms that accounting for the impact of furlough, the overall direction of change is still downward, albeit at a dampened rate as described in the Health and Safety Executive’s (HSE) technical report (PDF, 787KB).

Background

This tool brings together available indicators at England and local authority level on the wider determinants of health, with links to further resources. The Wider Determinants of Health tool is designed to:

• draw attention to the broad range of individual, social and environmental factors which influence our health
• provide the public health system with intelligence on the wider determinants of health to help improve population health and reduce health inequalities

The indicators that have been brought together for this tool are a combination of wider determinants, health behaviours and health outcomes.

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