Public Health Liverpool

Wider determinants of health

Wider determinants, also known as social determinants, are a diverse range of social, economic and environmental factors which impact on people’s health.  Variation in the experience of wider determinants (i.e. social inequalities) is considered the fundamental cause (the ‘causes of the causes’) of health outcomes, and as such health inequalities are likely to persist through changes in disease patterns and behavioural risks so long as social inequalities persist.

Key facts

  • Liverpool has the 3rd highest rate of violent crime in England, with around 397 emergency hospital admissions for violence each year.
  • In 2020/21, 131 children entered the youth justice system (10-17 years). The Liverpool rate of 3.3 per 1,000 was higher than England at 2.8 per 1,000 and the 5th highest in the North West.
  •  Liverpool was ranked 3rd highest out of 8 core cities in 2021/22 for its long-term unemployment rate of 3.9 per 1,000 population with around 1,333 people aged 16-64 years claiming job seekers allowance for more than 12 months.
  • In 2022/23 the average ‘Attainment 8’ score for pupils in Liverpool was 40.7% compared to 46.2% in England and the 5th lowest in the country. Attainment 8 measures pupils’ results in 8 GCSE-level qualifications.
  • 232,800 people aged 16-64 years were in employment in 2022/23. The proportion in employment is significantly below England (69.4% compared to 75.7%).
  • 27.2% of our economically inactive population were long-term sick in 2023 which was in line with the national average (27.2%).
  • Three in every five (58.7%) residents live in areas (LSOAs) which score in the poorest performing 20% on the healthy neighbourhoods (AHAH) index, the highest level in the North West.
  • The ratio of median house price to median gross annual earnings in 2023 was 4.9 compared to 8.3 in England meaning that on average, it is more affordable for people to buy a house in the city.
  • 18% of households in Liverpool were estimated to be in fuel poverty in 2021, the 4th highest in the North West.
  • Winter mortality is not solely a reflection of temperature, but of other factors as well, these include respiratory diseases and pressure on services. Between Aug 2021 - Jul 2022, there were 160 more deaths in Liverpool that occurred in the winter period (December to March) compared with the non-winter periods (August to November and April to July). Liverpool’s winter mortality index was in line with England (10% compared to 8.1%).
  • Every year 1,950 people aged 65 and over are admitted to hospital after a fall. Liverpool’s rate of emergency admission due to falls injuries in older people is the 9th highest in the country.
  • 62% of Liverpool adults known to mental health services in 2020/21 were in stable accommodation which was higher than nationally (58%) and the second highest among the core cities.
  • In 2022/23, 79.1% of working age adults with a learning disability were living in their own home, which was in line with England (80.5%).
  • There were 6,588 complaints about noise per thousand population in 2020/21. The Liverpool rate of 13.2 per 1,000 was significantly higher than the national average of 12.0 per 1,000.
  • Around 23 children aged under 16 are killed or seriously injured in road traffic accidents every year while Liverpool’s rate of 27.8 per 100,000 in 2020-22 was significantly worse than England (16.5).

View 'Wider Determinants of Health Profile', Public Health England