Framework
A Framework for Composite Indices and Sub-indices
This framework combines a small set of ward-level indices and sub-indices to capture key dimensions of health and economic opportunity. It brings together measures of economic conditions, health outcomes, healthcare quality and access, wider determinants, and condition-specific patterns. Scores are constructed consistently so that higher values always indicate more favourable conditions, making comparisons across wards clear and intuitive.
Main Index
Health outcome index
The Health outcome index is a composite ward-level measure spanning child health, emergency admissions, mental health, mortality and life expectancy. It is designed to summarise overall health outcomes rather than any single condition or service issue.
Indicator variables:
- Child health sub-index
- Emergency hospital admissions
- Life expectancy
- Mental health
- Mortality
Supporting sub-indices provide more detail on the component domains that sit underneath this headline measure.
Associated sub-indices:
Child health sub-index:
The Child health sub-index brings together birth outcomes, childhood overweight prevalence and emergency admissions among young children. It provides a more specific picture of early-life health conditions within each ward.
Indicator variables:
- Low birth weight of live babies 2021
- Reception prevalence of overweight (including obesity), 3 years data combined 2024
- Year 6 prevalence of overweight (including obesity), 3 years data combined 2024
- Emergency hospital admissions: all causes (aged under 5) 2021
Emergency hospital admissions sub-index:
The Emergency hospital admissions sub-index captures admissions for selected acute and chronic conditions. It helps distinguish places where urgent hospital use reflects a heavier burden of preventable or poorly controlled illness.
Indicator variables:
- Coronary heart disease: emergency hospital admissions
- Stroke: emergency hospital admissions
- Heart attack (myocardial infarction): emergency hospital admissions
- Chronic obstructive pulmonary disease (COPD): emergency hospital admissions
- Intentional self-harm: emergency hospital admissions
- Hip fracture: emergency hospital admissions (aged 65 and over)
Mortality sub-index:
The Mortality sub-index focuses on cause-specific mortality burden across major disease groups. It helps interpret whether weaker overall health outcomes are linked to a broad mortality profile across the ward.
Indicator variables:
- Mortality from cancer
- Mortality from cardiovascular disease
- Mortality from coronary heart disease
- Mortality from stroke
- Mortality from respiratory diseases
Cancer sub-index:
The Cancer sub-index captures ward-level cancer burden through incidence across four cancer types. It is included to give more specific context where cancer patterns may be contributing to broader health disadvantage.
Indicator variables:
- Cancer incidence: breast cancer
- Cancer incidence: colorectal cancer
- Cancer incidence: lung cancer
- Cancer incidence: prostate cancer
Main Index
Healthcare quality and access index
The Healthcare quality and access index combines a quality measure and an access measure to show where ward-level healthcare conditions are relatively stronger or weaker. It brings together preventable mortality with Access to Healthy Assets and Hazards (AHAH).
Indicator variables:
- Healthcare quality (mortality from causes considered preventable)
- Healthcare service (AHAH)
The framework also includes a Healthcare service sub-index to give a more detailed view of the service-access side of this domain.
Associated sub-index:
Healthcare service sub-index:
The Healthcare service sub-index summarises proximity to core healthcare services. It provides a more focused access measure than the broader Healthcare quality and access index and helps show where physical service accessibility may be acting as a constraint.
Indicator variables:
- Drive-time to nearest Dentist
- Drive-time to nearest GP Practice
- Drive-time to nearest Hospital
- Drive-time to nearest Pharmacy
Main Index
Wider determinants index
The Wider determinants index captures the social, environmental and place-based conditions that shape health and economic opportunity. It brings together deprivation-related domains, fuel poverty, and environmental conditions into a single comparative score.
Indicator variables:
- Air Quality domain score (AHAH)
- Barriers to Housing and Services domain score (IMD)
- Crime domain score (IMD)
- Education, Skills and Training domain score (IMD)
- Employment domain score (IMD)
- Fuel poverty
- Green/Bluespace domain score (AHAH)
- Income domain score (IMD)
- Living Environment domain score (IMD)