Where are our health inequalities?

Health inequality exists across Devon, for different groups of people and for different reasons.  At its simplest level, the variation in life expectancy across the county is stark.  Table 5.1 shows the most recent information for the life expectancy gap at ward level.

Table 5.1:  Overall, shortest and longest average life expectancy in years (LE) at birth by ward, Devon local authority districts, 2009 to 2013.

District District LE Shortest LE Longest LE Gap (years)
Ward Name LE Name LE
East Devon 82.8 Exmouth Littleham 80.0 Newton Poppleford and Harpford 89.6 9.6
Exeter 81.8 Newtown 77.4 Topsham 85.9 8.5
Mid Devon 83.0 Cullompton North 79.6 Upper Culm 85.9 6.3
North Devon 81.5 Ilfracombe Central 74.6 Chittlehampton 87.7 13.1
South Hams 82.9 Totnes Bridgetown 79.0 Marldon 86.7 7.7
Teignbridge 82.1 Newton Abbot: College 78.8 Kerswell-with-Combe 86.1 7.3
Torridge 81.8 Kenwith 79.6 Three Moors 89.2 9.6
West Devon 82.1 Okehampton West 79.7 Milton Ford 86.1 6.4
Devon 82.3 Ilfracombe Central 74.6 Newton Poppleford and Harpford 89.6 15.0

Source: Primary Care Mortality Database 2014 and Office for National Statistics Mid-Year Population Estimates

Health inequality may be most frequently linked to socio-economic deprivation but it affects all sectors of society – because factors such as gender, ethnicity, sexuality and disability all can be associated with health inequality.  These variations are considered in more detail in this chapter of this report.  The Equality Act 2010[] established a legal duty of equality for the people with the following characteristics which are known as “protected characteristics”:

  • age
  • disability
  • gender reassignment
  • marriage and civil partnership
  • pregnancy and maternity
  • race
  • religion or belief
  • sex (gender)
  • sexual orientation

The Act also includes a legal duty, on public sector organisations to which the legislation applies, “when making decisions of a strategic nature about how to exercise its functions, have due regard to the desirability of exercising them in a way that is designed to reduce the inequalities of outcome which result from socio-economic disadvantage”.


R5.1 Support reductions in health inequality by efforts to increase the prosperity of Devon, and schemes which increase people’s financial independence.
R5.2 The NHS must do more to improve the health of the worst-off in Devon, to meet its statutory responsibility for reducing health inequality.
R5.3 Commission a targeted approach to oral health promotion so that those children and young people most at risk of dental decay are helped to improve and maintain their oral health.
R5.4 Target screening and disease detection programmes to increase uptake from people who are socio-economically deprived or who may be more susceptible for reasons of ethnicity, sexuality or disability.
R5.5 Develop a strategy to target preventive interventions at younger populations who have a greater chance of developing ill-health in later life.
R5.6 Enable personalised health and care interventions much earlier to prevent the consequences of multi-morbidity on quality of life and on the use of health and care services.
R5.7 Capitalise on the opportunities presented by a universal primary care service to identify and manage pre-frailty.
R5.8 Implement the recommendations of the lesbian, gay, bisexual and transgender (LGBT) needs assessment.
R5.9 Undertake a detailed needs assessment of children in care, to include their own perspective of health, wellbeing and support needs, including recognition of their vulnerability to sexual exploitation.
R5.10 Implement multi-agency approaches to preventing homelessness and supporting those homeless people who have the most complex needs.
R5.11 Ensure the prioritisation of public mental health and mental health as a health and wellbeing priority.
R5.12 Reduce the number of section 136 detentions by Devon and Cornwall Police by providing better access to emergency mental health services.