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COVID-19 Health Inequalities Monitoring for England (CHIME) tool

Please be advised that the CHIME tool will be temporarily unavailable due to scheduled maintenance on 13 July 2023 between 15:00 and 17:00. We apologise for any inconvenience this may cause.

Updates to the CHIME tool are paused pending the results of a review of the content and presentation of data within the tool. The tool has not been updated since 16 March 2023. Please send any questions or comments to PHA-OHID@dhsc.gov.uk.

The CHIME tool brings together data relating to the impacts of COVID-19, for factors such as mortality rates, hospital admissions, confirmed cases, vaccinations and life expectancy.

By presenting inequality breakdowns, including by age, sex, ethnic group, level of deprivation, population density and region, the tool provides a single point of access in order to:

  • show how inequalities have changed during the course of the pandemic and what the current cumulative picture is
  • bring together data in one tool to enable users to access and utilise the intelligence more easily
  • provide indicators with a consistent methodology across different datasets to facilitate understanding
  • support users to identify and address inequalities within their areas and identify priority areas for recovery

Looking for data for local authorities?

  • The CHIME tool now provides data for local authorities:
    - All vaccination indicators for those aged 18+ are available for upper tier local authorities, and by age, sex, deprivation quintile, country of birth, disability status, educational attainment, English language proficiency, NS-SEC and household tenure within upper tier local authorities
    - Cumulative confirmed case rates of COVID-19 are available for upper tier local authorities, and by age, sex and deprivation quintile within upper tier local authorities
    - Cumulative mortality rates are available for upper tier local authorities, and by sex and deprivation quintile within upper tier local authorities. These include deaths from all causes, deaths involving COVID-19 and deaths not involving COVID-19
    - Cumulative hospital admission rates are available for upper tier local authorities, and deprivation quintile within upper tier local authorities
    - Click the Data tab above to access these
  • All vaccination indicators are available for those aged 50+ at upper tier local authority level on the ONS website.
  • Mortality rates for upper and lower tier local authorities are available for deaths due to COVID-19 and deaths involving COVID-19 registered in 2021 (all ages and under age 75) in the Fingertips Mortality Profile.
  • Excess deaths across the course of the pandemic to date are available for upper tier local authorities in the Excess Mortality tool for England.

Latest release

The latest release (16/03/2023) includes:

  • Existing indicators for deaths, hospital admissions and vaccinations have been updated
  • Data on inequalities in vaccination uptake within upper tier local authorities have been added to the tool for the first time
    • These replace data for lower tier local authorities, published in December 2022, allowing the reporting of a wider range of inequality breakdowns within these areas

Indicators

For deaths, hospital admissions and confirmed cases, the tool provides monthly and cumulative age-standardised rates, and monthly numbers. For vaccination uptake, cumulative percentages and age-standardised cumulative percentages are provided. Inequality in life expectancy is measured using the Slope Index of Inequality (SII).

Confidence intervals are not displayed in the charts but are available from the Data Tables and can be downloaded with the rates, percentages and SII estimates.

Inequality breakdowns

For deaths, hospital admissions and confirmed cases, data are presented for England and the English regions. Within each of these geographies, the following breakdowns are available:

  • Sex
  • Age
  • Deprivation deciles
  • Population density deciles
  • Broad ethnic groups

For all three mortality themes, hospital admissions and confirmed cases, subregional rates are available for cumulative rates only.

More detailed ethnic groups for the Asian and Black groups are available for England only.

Rates for ethnic groups within regions are all cumulative, rather than being available by month. However, monthly counts have been provided.

For vaccination uptake, the following breakdowns are available within England and the English regions:

  • Sex
  • Age group
  • Deprivation quintile
  • Ethnic group
  • Country of birth
  • Disability status
  • Educational attainment
  • NS-SEC
  • Religion
  • Rural-urban
  • Household tenure

For all vaccination indicators, subregional rates for those aged 18+ are available by age, sex, deprivation quintile, country of birth, disability status, educational attainment, English language proficiency, NS-SEC and household tenure.

The life expectancy estimates are available by deprivation decile within England and the English regions.

Publication schedule

Publication 17: 16/03/2023

  • Existing indicators for deaths, hospital admissions and vaccinations have been updated
  • Data on inequalities in vaccination uptake within upper tier local authorities have been added to the tool for the first time
    • These replace data for lower tier local authorities, published in December 2022, allowing the reporting of a wider range of inequality breakdowns within these areas

Publication 16: 15/12/2022

  • Existing indicators for deaths, hospital admissions and vaccinations have been updated
  • Data on inequalities in vaccination uptake within lower tier local authorities have been added to the tool for the first time

Publication 15: 15/09/2022

  • Existing indicators for deaths, hospital admissions and vaccinations have been updated
  • Confirmed cases for ethnic groups, which had previously only been available to December 2021, have now been updated to March 2022, and trend data have been revised
  • Changes have been made to the confirmed case rates presented for all ages, with age-standardised rates replaced by crude mortality rates

Publication 14: 21/07/2022

  • Existing indicators for deaths and vaccinations have been updated
  • It has not been possible to update hospital admissions indicators in this release so the latest data remain for February 2022.
  • Because of the changes to COVID-19 testing in England in April 2022, the existing indicators of confirmed cases are no longer being updated within the tool

Publication 13: 16/06/2022

  • Existing indicators for deaths and hospital admissions have been updated
  • It has not been possible to update vaccination indicators in this release so the latest data remain for March 2022. Data for April 2022 have been published by the Office for National Statistics here and will be added to CHIME in the next release on 21 July 2022
  • Because of the changes to COVID-19 testing in England in April 2022, the existing indicators of confirmed cases are no longer being updated within the tool

Publication 12: 19/05/2022

  • Existing indicators for deaths, hospital admissions and vaccinations have been updated
  • For COVID-19 related hospital admissions, cumulative monthly admission rates are now available for upper tier local authorities and deprivation quintiles within these areas
  • Indicators of COVID-19 vaccination uptake are now available for all inequality breakdowns by sex, for those aged 18 and over and 50 and over, within England as a whole
  • Because of the changes to COVID-19 testing in England in April 2022, the existing indicators of confirmed cases are no longer being updated within the tool

Publication 11: 21/04/2022

  • Existing indicators for confirmed cases, deaths and vaccinations have been updated
  • The impact of the change to the COVID-19 case definition on data for ethnic groups is still being investigated, and so data for confirmed cases broken down by ethnic group have not been updated in this release. Existing data (to December 2021) remain within the tool but are based on the previous case definition which did not include reinfections
  • It has not been possible to update hospital admission indicators in this release. In the next release (on 19 May 2022) we expect to be able to update these indicators to January 2022

Publication 10: 17/03/2022

  • New data for upper tier local authorities: for deaths from all causes and deaths not involving COVID-19, cumulative mortality rates are now available for LAs and deprivation quintiles within LAs. These supplement existing indicators for deaths involving COVID-19
  • Life expectancy estimates and life expectancy breakdowns updated with provisional 2021 data, including deprivation deciles within England and the English regions, and a measure of the inequality gap within these areas
  • Existing indicators for confirmed COVID-19 cases have been updated, and a change to the COVID-19 case definition has been adopted, which now includes possible reinfections
  • The impact of this change on data for ethnic groups is still being investigated however, and so data for confirmed cases broken down by ethnic group have not been updated in this release. Existing data (to December 2021) remain within the tool but are based on the previous case definition which did not include reinfections
  • Existing indicators for hospital admissions, deaths and vaccinations have been updated

Publication 9: 17/02/2022

  • New data for upper tier local authorities: for deaths involving COVID-19, cumulative mortality rates are now available for LAs and deprivation quintiles within LAs. Local authority data for deaths from all causes and non-COVID deaths will follow in the next CHIME update
  • Existing indicators for hospital admissions, deaths and vaccinations have been updated, but an update for indicators of confirmed COVID-19 cases has not been possible in this release

Publication 8: 20/01/2022

  • New indicators added for adults who have received three vaccinations (people receiving three doses of the vaccine or two doses and a booster)
  • For local authorities, cumulative confirmed case rates are now available by sex and age group
  • Population density deciles updated using mid-2020 population density
  • Existing indicators for deaths, confirmed cases and vaccinations updated
  • It has not been possible to update hospital admission indicators in this release. In the next release (on 17 February 2022) we expect to be able to update these indicators to October 2021.

Publication 7: 16/12/2021

  • New subregional indicators for confirmed cases: cumulative rates for confirmed cases for upper tier local authorities and deprivation quintiles
  • Existing indicators for deaths, confirmed cases and vaccinations updated

Publication 6: 18/11/2021

  • Life expectancy and life expectancy breakdowns updated with final 2020 data
  • Ethnicity indicators within the hospital admissions theme have been updated
  • Existing indicators for deaths, confirmed cases and vaccinations updated

Publication 5: 28/10/2021

  • New indicators for vaccinations
  • Additional age breakdowns for deprivation and ethnic group indicators within deaths, hospital admissions and confirmed cases
  • Updated hospital admissions data to use finalised 2020/21 Hospital Episode Statistics (HES) data, rather than provisional data
  • Existing indicators for deaths, hospital admissions, confirmed cases and vaccinations updated

Publication 4: 09/09/2021

  • New indicators for non-COVID-19 deaths, all cause deaths, life expectancy and life expectancy breakdowns
  • Existing indicators for COVID-19 deaths, hospital admissions, confirmed cases and vaccinations updated

Publication 3: 05/08/2021

  • New indicators for vaccination coverage in those aged 50 and over added
  • New inequality breakdown showing population density deciles added for deaths, hospital admissions and confirmed cases
  • Existing indicators for deaths, hospital admissions and confirmed cases updated

Publication 2: 24/06/2021

  • New indicators for confirmed cases of COVID-19 added
  • Existing indicators for deaths and hospital admissions updated

Publication 1: 20/05/2021

  • CHIME tool launched with indicators for deaths involving COVID-19 and hospital admissions where COVID-19 was primary reason for the admission
  • Inequality breakdowns include age, sex, ethnic group, level of deprivation and region

Other resources

The work supplements the 'Disparities in the risk and outcomes of COVID-19' report, published in June 2020.

The Fingertips Mortality Profile brings together key mortality indicators for local authorities in order to make it easier to assess outcomes across a range of causes of death. The profile includes indicators for deaths due to COVID-19 and deaths involving COVID-19, for deaths registered in 2021.

Feedback

We are interested in your feedback on the tool. If you have any comments or suggested changes, please contact us.

Main messages

The March update of the CHIME tool includes updates of the indicators for deaths and vaccination uptake to January 2023. Indicators of hospital admissions for COVID-19 have been updated to November 2022.

Data for recent months show that deaths involving COVID-19 and hospital admissions for COVID-19 were lower than in the same periods 12 months previously, but patterns seen throughout most of the pandemic have continued, with the highest monthly rates in the most deprived areas of England, and the lowest rates in the least deprived areas. For deaths involving COVID-19 in England, the mortality rate for January 2023 (52 per 100,000 population) was significantly lower than in January 2022, when it was 122 per 100,000. The hospital admission rate for COVID-19 in England in November 2022 was 97 per 100,000, significantly lower than in November 2021 (343 per 100,000).

Data on inequalities in COVID-19 vaccination uptake within upper tier local authorities have been added to the tool for the first time. These replace data for lower tier local authorities, published in December 2022, allowing the reporting of a wider range of inequality breakdowns within these areas, including sex, age group, deprivation quintile, country of birth, disability status, educational attainment, English language proficiency, NS-SEC and household tenure.

Within England as a whole, 84.6% of people living in the least deprived fifth of areas had received three vaccinations by January 2023, but for people in the most deprived fifth of areas this figure was only 59.9%. Within all LAs, the percentage who had received 3 vaccinations was higher in the least deprived areas than in the most deprived areas. In 61 LAs, the difference between most and least deprived was more than 20 percentage points.

The biggest inequality in vaccine uptake was within Bradford, where there was a gap of 41.7 percentage points between those living in its most and least deprived areas who had received 3 vaccinations. Within Rutland, there was a difference of only 2.2 percentage points between the most and least deprived. (These results are based on dividing the population into roughly equal groups based on their level of deprivation within local authorities. They therefore reflect the very different distribution of deprived areas both between and within LAs.)

Data


Download data for selected indicator (for all geography types:
Download data (.csv)

Download data for all indicators within theme (for England and regions):
Download data (.csv)
  • Charts
  • Data Table
  • Metadata


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How to use this tool

The tab 'Data' provides visualisations of selected indicators by different breakdowns and their trends over time.

  1. Select the theme, eg deaths or hospital admissions.
  2. Select the indicator to display in the 'Indicator' drop down.
  3. Select geography type. Data for upper tier local authorities are available for all vaccination indicators and cumulative rates within the following themes:
    • Deaths - COVID-19
    • Deaths - non-COVID-19
    • Deaths - all causes
    • Hospital admissions
    • Confirmed cases
  4. Select the dimension of inequality you would like to display from the ‘Breakdown’ drop down. The dashboard will populate with the selected data.
    • If 'Region' is selected as the geography type, and the inequality breakdown selected is not 'Region', a second geography drop down will appear to select the region of interest.
    • If 'Local Authority' is selected as the geography type, two drop down selection boxes will appear. The first will allow you to select the region of interest, and the second will allow you to select a local authority within the region selected.
  5. Select age group, where available.
  6. Some breakdowns can be further broken down by sex by selecting buttons displayed on the chart.
  7. Navigate between viewing charts, data tables and metadata using the tabs in each theme.
  8. To see a single variable on a chart, such as a particular ethnic group or deprivation decile, click on the variable name in the legend.
  9. To download all data for a specific indicator, or to download data for all indicators within a specific theme for England and regions, select the buttons provided on the sidebar.

To access our companion tool on the Wider Impacts of COVID-19 on Health, click on the 'Wider Impacts of COVID-19 - WICH tool' tab and follow the link.

How to use the charts effectively

This document provides guidance on all the functionality available for the charts.

Wider Impacts of COVID-19 on Health (WICH) monitoring tool

The Wider Impacts of COVID-19 on Health (WICH) monitoring tool is designed to allow you to explore the indirect effects of the COVID-19 pandemic on the population's health and wellbeing. WICH presents a range of health and wellbeing metrics in interactive plots that can be broken down to show differences between groups - for example, you can explore grocery purchasing habits by region or social class. WICH is updated monthly and may include the addition of new metrics as they become available.

A range of other Office for Health Improvement and Disparities analytical tools are available here.

Mortality Profile - Fingertips

The Fingertips Mortality Profile brings together key mortality indicators for local authorities in order to make it easier to assess outcomes across a range of causes of death. The profile includes indicators for deaths due to COVID-19 and deaths involving COVID-19, for deaths registered in 2021.

For all local authorities in England, the tool provides age-standardised mortality rates for deaths due to COVID-19 (deaths with COVID-19 specified as the underlying cause of death) and deaths involving COVID-19 (deaths with a mention of COVID-19 anywhere on the death certificate). These rates are available for all ages and for deaths under age 75, for males, females, and persons.

Accessibility statement for COVID-19 Health Inequalities Monitoring for England (CHIME) tool

This accessibility statement applies to https://analytics.phe.gov.uk/apps/chime/

This website is run by the Office for Health Improvement and Disparities. We want as many people as possible to be able to use this website. For example, we aim for every user to be able to:

  • change colours, contrast levels and fonts
  • navigate most of the website using just a keyboard
  • navigate most of the website using speech recognition software
  • listen to most of the website using a screen reader (including the most recent versions of JAWS, NVDA and VoiceOver)

We also aim for the website text as simple as possible to understand. AbilityNet has advice on making your device easier to use if you have a disability.

How accessible this website is

We know some parts of this website are not fully accessible:

  • The graphs and charts may not be usable if you rely on the keyboard, struggle with colors, or use a screenreader. The data tables associated with each should be more usable.
  • Not all the text will be available when you zoom in.
  • Some text and graphics do not have sufficient contrast.
  • You cannot skip to the main content when using a screen reader, and most pages missing landmarks.
  • Some page updates (when searching or filtering) do not announce the updates to screenreaders.

Feedback and contact information

If you need information on this website in a different format like accessible PDF, large print, easy read, audio recording or braille, please email us. We’ll consider your request and get back to you in 5 working days.

Reporting accessibility problems with this website

We’re always looking to improve the accessibility of this website. If you find any problems not listed on this page or think we’re not meeting accessibility requirements, please email us.

Enforcement procedure

The Equality and Human Rights Commission (EHRC) is responsible for enforcing the Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018 (the ‘accessibility regulations’). If you’re not happy with how we respond to your complaint, contact the Equality Advisory and Support Service (EASS).

Technical information about this website’s accessibility

Office for Health Improvement and Disparities is committed to making its website accessible, in accordance with the Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018.

Compliance status

This website is partially compliant with the Web Content Accessibility Guidelines version 2.1 AA standard, due to the non-compliances listed below.

Non-accessible content

The content listed below is non-accessible for the following reasons.

Navigation

  • Graph controls could not be accessed with a keyboard alone
  • A feature to skip over the navigation and filters to go directly to the main content was not provided
  • It is not possible to dismiss content on the navigation bar that appears on-hover with keyboard only

Images

  • A number of icons and images were missing alternative text

Colours

  • The colour contrast of text and the graph controls was insufficient

Structure

  • ARIA landmarks such as main & banner were missing
  • The language of the page had not been set
  • The current page state is visually communicated but not programmatically communicated
  • Important changes in content that occur dynamically are not announced to screen reader users
  • Lists were not used to group contents in some areas
  • HTML was not nested according to the specification

Graphs

  • The graphs require colour vision to interpret, failing Use of Color
  • Icons used in the graphs, and some colour combinations fail Non-Text Contrast
  • The keyboard controls are not Keyboard accessible
  • The graphs do not have alt-text, failing Non-Text Content
  • The text within the graphs are not structured, failing Info and Relationships

What we’re doing to improve accessibility

Most of the issues above will be reviewed with the development team. The graphs are created using a library, and it has not been possible to find an accessible alternative. The data tables associated with each graph will be updated to ensure they include the same information as the graph.

Preparation of this accessibility statement

This statement was prepared on 23rd September 2021. It was last reviewed on 23rd September 2021. This website was last tested on 22nd September 2021. The test was carried out by Nomensa. A selection of 10 pages across the site were selected for testing, covering the main templates and types of content (graphs) that are available.