In December 2019, it was reported that Worcester was the 9th worst council area in the UK for the increase in deprivation between 2015 and 2019. It was a shock to find Worcester listed alongside Oldham, Walsall and Gateshead. This jarred with Worcester’s self-image of a nice, middle-class city which is a great place to visit, live and work in. Whilst progress was being made in economic and cultural development in the city centre, other communities were apparently going backwards.
How did Worcester achieve this dubious accolade? There has been an increase in the number of ‘lower super output areas’ in the city which are in the bottom 10% of Index of Multiple Deprivation, from 5 to 8. What does that mean? Worcestershire Public Health looked at the statistics and did a presentation at the March 2020 Healthy Worcester multi-agency meeting, which I chair.
Index of Multiple Deprivation (IMD) is the official measure of relative deprivation in England. It is based on 39 factual measured statistics which are routinely collected by a wide range of agencies. It is not based on surveys or opinions. There are 7 different domains of deprivation:
- Income deprivation
- Employment deprivation
- Education, skills and training deprivation
- Health deprivation and disability
- Barriers to housing and services
- Living environment deprivation
These are measured within a Lower Super Output Area (LSOA) which consists of approximately 1,500 people. The 32,844 LSOAs in England are then ranked according to their deprivation score and split into 10 equal groups or deciles. IMD enables comparison of deprivation between areas and over time. It can also be used to target resources and projects and bid for funding.
At Worcestershire County Council level, there has been an increase in the number of LSOAs in the 10% most deprived nationally over time – from 13 in 2010, to 16 in 2015 and 18 in 2019. Redditch and Wyre Forest councils actually have the greatest deprivation with 40% and 34.5% respectively of their population living in the top 30% of most deprived areas in England. Nevertheless in 2019, a quarter of Worcester citizens are living in the top 30% of deprivation and 11.6% in the top 10% most deprived. The LSOAs in Worcester which ‘newly’ came into the worst 10% deprivation category did so due to deterioration in measures relating to crime, health and disability, barriers to housing and services and income.
In order to understand how to make a difference, it is necessary to look more closely at the specific indicators. Interestingly, staff at Platform, which is the biggest social landlord in the deprived areas of Worcester, had looked at the data too. Without knowing the measures used, agencies don’t know if the answer is to plant more trees or set up job clubs. And it is possible to improve relative deprivation levels over time. 8 out of 10 of the most improved local authorities in the 2019 report are in inner London, with Tower Hamlets doing the best. I will explore those domains of deprivation which have worsened in Worcester City in the last 4 years.
Crime was a factor in every ‘new’ most deprived LSOA in Worcester. In the case of Brickfields, it came into the 10% most deprived category due only to increased crime. The indicators in the crime domain are rates per 1,000 at risk population – rates of violence, burglary, theft and criminal damage. Do West Mercia Police and the Police and Crime Commissioner recognise this data? Are Safer Worcester partners aware of the deterioration in crime statistics in these areas of the city? What additional crime prevention or victim support measures are required to reverse this trend? Should police and other resources be switched from other areas?
The health and disability domain consists of 4 measures – years of potential life lost, acute morbidity, comparative illness and disability ratio and mood and anxiety disorders. Earlier deaths and poor health in deprived communities has been well documented over a prolonged period. In August 2018, Worcester News reported that people in Warndon and Nunnery died 10 years younger than in St Peter’s. However, Worcestershire County Council’s own Joint Strategic Needs Assessment (JSNA) identified increasing inequalities in life expectancy at birth as a new issue in 2019. To quote ‘more deprived people are living shorter lives than the least deprived people’. Morbidity is a measure of living with disease or illness. Those living in deprived communities are more likely to live with poor health and chronic conditions. There is an inequality gap in Worcestershire of about 15 years for healthy life expectancy, i.e. 15 years longer of being unwell before dying.
Worcestershire County Council JSNAs provide the data and the analysis. ’Health inequalities are avoidable and unfair differences in health status between groups of people or communities. Variation in the experience of wider determinants of health (social inequalities) is considered the fundamental cause of health inequalities’. There is an extensive literature and evidence base on how to reduce such inequalities. Some local authorities are more focussed or successful in achieving improvements than others.
The IMD measures within barriers to housing and services are split into geographical barriers and wider barriers. The former measures are road distance to a post office, primary school, general store or supermarket and GP surgery. Has the closing of local post offices increased deprivation in Worcester? Is that of any concern to a private business which can’t afford loss making branches? How far do people from deprived communities have to travel to see their GP? Why are there no GP surgeries in Rainbow Hill?
The wider measures are household overcrowding, homelessness and housing affordability. In January 2020 there were 4,627 people on Worcester City Council’s housing waiting list. Building more affordable housing for rent would address this need and the wider measures. It is a longstanding goal of the City plan which has been challenging to achieve.
The income deprivation measures all relate to numbers of adults and children in families claiming benefits such as income support, Job Seeker’s Allowance, employment support, pension credit, working tax credit, child tax credit and Universal Credit. Increases in this deprivation measure represent a direct increased cost to the state. Is this the impact of the ‘gig economy’ and insecure work hitting more families? There is anecdotal evidence that some national retail chains, for example, are only giving part-time contracts to their staff. These low-income working families then have to claim benefits to supplement their income and make ends meet. Nearly a fifth of children in Worcester City are growing up in poverty. The average wage across Worcester is only £24,500, so many households are trying to manage on much less. Do our economic development plans address these issues? What is the most effective way to increase household income within deprived communities?
Deprived communities will always be with us because IMD is a relative measure. There will always be some who are less well off than others. The concern for Worcester is that our deprived communities are growing and the inequality gap is widening. The new national administration elected in 2019 aspires to ‘levelling up’. The challenge for all, involved in any level of government, is how to level up and not lose sight of the needs of our deprived communities.
Lynn has been a Worcester City Councillor since 2012. She was the Labour Parliamentary Candidate for Worcester in 2019. She spent the whole of her working life in the NHS, as a pharmacist and in a variety of management roles. She got an MBA from Aston University a long time ago.