A few days ago I posted a pic from some analysis done in Sheffield with the bold strap line of “second most important chart in contemporary health care”
Whether it IS indeed the second, third or most is probably immaterial
I was then asked for my view on the most. Others then suggested others. It’s probably impossible to suggest a “single”
Here are a few
Let me have others and I will add them to this top of the pops
Here is my take. With a line or two on each
1) the jaws of doom
This is from the Scottish Deep End crew.
Demonstrates the relatively flat shape of the curve of funding per capita in primary care with steep slope of need. Important if you are making a case for equitable (not equal) distribution of resources.
2). The fall off in historic improvements in life expectancy
This is a HUGE deal. I and many others have blogged on this. The same is happening re healthy life expectancy.
This was updated in the 2018 Health Profile
3). Life expectancy and heathy life expectancy by deprivation decile
Note the differences of years not in good health comparing best and worst. This drives demand for services.
3a). Healthy life expectancy split by deprivation
4). Multi morbidity prevalence by age and deprivation
Note the relatively big differences between best and worst in terms of % prevalence at a certain age. This chart at a stroke blows a significant hole in the “ageing population spells certain doom” hypothesis
This analysis from the Health Foundation is a version of the same broad story
- By the time they reach age 55-59, only 50% of people living in the most deprived local areas report good health. In contrast, in the least deprived areas, 85% of people in this age bracket still report good health. Flipping this sideways, in the most affluent areas, the share of people reporting good health doesn’t drop to 50% until age 75-79 – a whole 20 years later than in the most socioeconomically deprived.
Think that one through from the perspective of working lives / economic productivity, ability to care, NHS and social care demand.
5). The law of diminishing marginal returns is simple, yet mostly overlooked. Meanwhile harm goes up linearly.
Accept that my value judgement
6). The graph of doom. All consuming if you are working in social care. Money in vs demand.
7) Healthcare costs across lifecourse (CHE)
Note the gradient in cost across social divides. Reference here
8). Chris Bentley’s inverse care map
Equity is key to reducing inequality. This useful illustration may mirror what dietetic depts see. Given greater levels of need in the most deprived areas, u would expect to see higher elective surgery in deprived areas instead these ppl often arrive as emergency
Underscoring the importance of mental health. Writ large.
And taking a longer term (though it is a very immediate and here and now issue) and global AND local issue
Policy thresholds in mitigation
11). This is what #northernpowerhouse should be there to fix! There was no North/South divide in mortality until 1995 and look at it now @michaelmarmot
12). Y6 boys obesity trend across 10 years of the NCMP by deprivation quintile.
From @PHE_uk @PHE_obesity. Frightening – #inequality widening all the time.
All the more reason for way upstream interventions
Unlikely to be a problem solved by service offer one person at a time, depth of coverage, effectiveness of intervention in toxic environment
Another @MichaelMarmot one – highlighting just how early in a child’s life inequalities in outcomes are seen
nick Hassey suggested an important caveat
“While disadvantage certainly emerges early, this discussion highlights concerns Feinstein (the original author) does not account for regression to the mean or measurement error properly.
So there’s certainly divergence between rich and poor but the “cross-over” in that graph is contested at *best* – and leads us to focus too much on early years as a silver bullet. When actually it’s sustained effort over several key stages that is key
And it’s worth stressing, that there’s a gap that emerges early b/w well off and more disadvantaged kids is well evidenced. It’s probably just smaller & the “cross-over” bit probably doesn’t exist”
14). The slowing of historic falls in infant mortality over recent years
Harry Rutter, says this one from the IPPC report is – by far – the most important chart in the whole word, ever, for anything
Who am I to disagree
He is a global professor and everything
16) complex lives vs social deprivation
What are your favourites.
I’ll add to this as they come