The Work of the Public Health Observatories Dr Bobbie Jacobson Director, London Health Observatory .
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Transcript of The Work of the Public Health Observatories Dr Bobbie Jacobson Director, London Health Observatory .
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The Work of the Public Health Observatories
Dr Bobbie JacobsonDirector, London Health Observatory
www.lho.org.uk
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The role of the Public Health Observatories (PHOs)
To work in partnership with researchers, regional and local health policymakers and practitioners to:
• Monitor trends in health and its determinants;• Highlight future health problems;• Assess the health impact of potential and past policies• Draw together information from different sources and to
identify groups in formationAdapted from “Saving Lives-Our Healthier Nation”
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The Association of Public Health Observatories (APHO) - At A Glance
www.pho.org.ukNATIONAL LEAD AREAS
Eastern Region PHOwww.erpho.org.uk
Primary Care
London PHOwww.lho.org.uk
InequalitiesSocial Exclusion, Regeneration
North West PHOwww.nwpho.org.uk
Sexual HealthHIV and AIDS, Drug Misuse
Northern & Yorkshire PHOwww.nypho.org.uk
Mental HealthPrisons / National datasets
South East PHOwww.sepho.org.uk
Coronary Heart DiseaseMen’s Health
Trent PHOwww.trentpho.org.uk
Teenage PregnancyDiabetes
West Midlands PHOwww.wmpho.org.uk
CancersOlder People, Environment
South West PHOwww. swpho.org.uk
InjuriesChildren
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The Public Health Observatories: Spectrum of Activity
One stop access Tools and methods Support Public Healthto information for data analysis and health/ data intelligence networks
Query desk: Comparative CommunicationInformation and analysis/interpretation and advocacy forData of health related data/ better public
Policy implementation health information
RESPONSIVE PRO-ACTIVE
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The Public Health Observatories: Pivotal Role In
Public Health Intelligence?
R&D PractitionersLHO
DH andgovernment
policy
RegionalGovernment
RegionalSurveillance
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Association of Public Health Observatories:
Examples Of Current Joint Work• Primary Care: Developing a common dataset of PCT health
indicators (ERPHO)
• Health inequalities: Developing a basket of local indicators and a tool kit on health equity audit, review of ethnicity & vital statistics (LHO)
• CHD: Equity profiling (SEPHO)
• Access to datasets: eg. Hospital, HES, ONS mortality dat from DoH, ONS and CDSC (Communicable Disease Surveillance Centre) (N&Y PHO)
• National Website: Developing a central point of access for all PHO users (NWPHO)
• Common Electronic Search Language: Devising a common thesaurus of search items across all PHOs and HAD (ERPHO)
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LHO Current Work Programme 2002/3
1. Network Development and Communications
2. Website Development
3. Widening Data/Information Access
4. Health Impact Assessment
5. Tackling Health Inequalities
6. “Diversity Counts” - Ethnic Health Intelligence Programme
7. PCT information programme
8.National/International work
9. Mental Health
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One Stop Access to Data / Information - some examples
• London data on illicit drugs
• EU Alcohol policy / harm in young people
• London Injury and Accidents Local Datasets
• Census: specially commissioned data (GLA/PCTs)
• HES data
• Crime and A&E data
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National targets for tackling Health Inequalities
• Infant Mortality (Deaths in the first year of life) “Starting with children under one year, by 2010 to reduce by at least 10% the gap in mortality between routine and manual groups and the population as a whole”
• Expectation of Life “Starting with local authorities, by 2010 reduce by at least 10% the gap between the fifth of areas with the lowest life expectancy at birth and the population as a whole.”
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Additional Targets with an Inequalities Dimension
• To reduce smoking rates among manual groups from 32% in 1998 to 26% by 2010.
• To reduce conception rates in under 18s by 15% by 2004 and 50% by 2010, while reducing the gap between the worst fifth of wards and the average by at least a quarter.
• To reduce child poverty by half in ten years and eradicating it in a generation.
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Life Expectancy at Birth in London 2001Male Female
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Life Expectancy in London by Deprivation Quintile (1997-9)Source: “Mapping Inequalities in Health Across London”, LHO
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1 2 3 4 5
deprivation quintile
exp
ecte
d y
ea
rs o
f li
fe
males
females
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Geographic Inequalities in Infant Mortality in London by Borough
1999-2001Source: “Health In London Report”, forthcoming
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Infant Mortality by Index of Deprivation
Source: “Health In London report”, forthcoming
R2 = 0.4273
0
1
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0 10 20 30 40 50 60 70
Index of deprivation - index of ward scores
Infa
nt
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rta
lity
ra
te
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Infant mortality rates by social class and registration type 1993-99
0123456789
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non-manual manual inside marriageand couple
registrations
soleregistrations
infa
nt
mo
rtal
ity
rate
England London
Target groups
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Specific infant mortality rates by registration type, London 1993-99
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Stillbirth rate Perinatalmortality rate
Neonatalmortality rate
Postneonatalmortality rate
Infant mortalityrate
Infa
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mo
rtali
ty r
ate
Sole registrations Inside marriage/couple registrations
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Infant mortality rates by mothers birthweight and registration type,
London 1993-99
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1500-2500 grams 2500+ grams
Infa
nt
mo
rtality
rate
Sole registrations Inside marriage/couple registrations
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Next Steps
• Detailed analysis of risk factors from North West Thames Maternity Dataset (SMMIS)
• Development of statistically valid proxy indicator (set) at PCT / local authority level