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 2019/20 for its long-term unemployment rate of 6.8 per 1,000 population aged 16-64 years (2,285 people) claiming job seekers allowance for more than 12 months.
  • In 2020/21 less than half (46.2%)of Liverpool pupils achieved an average attainment 8 score at Key Stage 4, which was significantly worse than the England average (50.9%) and the 8th lowest in the country.
  • 239,600 people aged 16-64 years were in employment in 2020/21. The proportion in employment was significantly below the national average (71.7% compared to 75.1%) and the 4th lowest among the core cities.
  • Almost a third (32%) 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.
  • 18.1% of households in Liverpool were estimated to be in fuel poverty in 2019, 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 2,280 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 4th 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 2020/21, 85.2% 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 (78.3%) and the third best out of the core cities.
  • There were 3,102 complaints about noise per thousand population in 2019/20. The Liverpool rate of 6.2 per 1,000 was similar to the England average of 6.4 per 1,000.

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