Developing the Health Index for England

In 2018, Dame Sally Davies, then Chief Medical Officer, called for an official index on England’s health. Her aim was to ensure that “health is recognised and treated as one of our nation’s primary assets…alongside GDP and the Measuring National Well-being programme.” As consultation on the proposed index gets under way, Greg Ceely explains the development work ONS has undertaken so far and what the provisional findings show.

The proposal outlined in the 2018 report Health 2040 – Better Health Within Reach made clear that the health index needed to be inclusive in the concept of health, by not only including the measurement of health outcomes but also factors that are known to contribute to health, both on an individual and collective level.

Using a broad definition of health, including health outcomes, health-related behaviours,  personal circumstances, and wider determinants of health such as air pollution, the ONS has been developing a new experimental Health Index for England, providing a single value to measure the health of the nation – with plans to expand further.

What does the Health Index provide?

The Health Index provides a single value for health showing how health changes over time, and can be broken down to focus on specific topics to show what is driving these changes.

It aims to improve the health of the nation by helping to focus public debate and policy attention across government on a broad concept of health and ‘healthiness’, by providing a highly visible and top-level measure of health.

It can track changes over time, with the potential to be broken down to monitor and better understand the drivers of health for different groups. The Health Index also provides a measure of health for local authority areas to allow for comparison between areas.

How does the Health Index work?

The main aim of the index is to provide a single value representing a broad definition of health.

As well as providing the headline measure of health, the Index can be broken down into further domains allowing users to better understand any changes over time or differences between areas, as well as to focus on a particular aspect of the index if that is what is of interest.

Currently, the domains split the index into three broad areas:

  • Healthy People – focusing on health outcomes such as life expectancy, health conditions and personal well- being.
  • Healthy Lives – health-related behaviours and personal circumstances such as smoking, alcohol misuse, unemployment and working conditions
  • Healthy Places – wider determinants of health, environmental factors including access to green space, air pollution and access to amenities (such as housing, GP surgeries).

Beyond these domains, users can explore further to look at England and local authority scores on individual topics and indicators.

What are the provisional findings?

The provisional findings suggest that health in England has declined from 2017 to 2018, after remaining stable for a few years. However, between 2015 and 2017, England’s “Healthy Lives” score steadily improved, offsetting a stable decline in “Healthy People” and “Healthy Places” scores over the full period presented.

Working with Lane Clark & Peacock LLP we have developed a beta web tool for exploring the Health Index further, which illustrates the type of presentation possible for the Health Index and its findings.

What’s next?

The Health Index is still under development with plans to expand, so we are keen to understand which aspects of the beta version are the most useful, and how it can be improved.

We welcome feedback from anyone with an interest in health and health policy. In particular, we would like feedback from analysts working in government both national and local along with analysts and researchers in other settings, such as academics, think tanks and charities.


Profile image Greg Ceely

Greg Ceely
Head of Health Index and Projections