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 highest rate of violent crime in England, with around 622 emergency hospital admissions for violence each year.
  • In 2020/21, there were 131 children in 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 6th 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 jobseekers allowance for more than 12 months.
  • In 2021/22 the average ‘Attainment 8’ score for pupils in Liverpool was 43.9% compared to 48.7% in England and the 9th lowest in the country. Attainment 8 measures pupils’ results in 8 GCSE-level qualifications.
  • 247,000 people aged 16-64 years were in employment in 2021/22. The proportion in employment is increasing and in line with the national average (74.3% compared to 75.4%).
  • Three in every 5 (58.7%) of 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 2021 was 5.2 compared to 9.1 in England meaning that on average, it is more affordable for our residents to buy a house in the city.
  • 18.7% of households in Liverpool were estimated to be in fuel poverty in 2020, the 2nd highest in the North West.
  • The number of excess winter deaths depends on the temperature and the level of disease in the population as well as other factors, such as how well-equipped people are to cope with the drop in temperature. There were 210 excess winter deaths in the city between Aug 2019 - Jul 2020. Liverpool’s excess winter deaths ratio was in line with England (14.9 compared to 17.4).
  • Every year 2,065 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 7th 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 best among the core cities.
  • In 2021/22, 82.9% of the working-age population who were known to have a learning disability were living in their own home which was significantly better than nationally (78.8%) and the third best out of the core cities.
  • 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 England average of 12.0 per 1,000.
  • Around 18 children aged under 16 are killed or seriously injured in road traffic accidents every year while Liverpool’s rate of 20.4 per 100,000 in 2018-20 was higher but not significantly different to the England average (15.9).

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