Reducing Health Inequalities in Bradford
and Airedale Districts
Knowledge and Intelligence from
Public Health England
20 November 2013
Jake Abbas, Associate Director
Northern and Yorkshire Knowledge and Intelligence Team
PHE
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
1
Our Mission
“To protect and improve the nation’s
health and to address inequalities,
working with national and local
government, the NHS, industry,
academia, the public and the voluntary
and community sector.”
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
Session Plan
• Knowledge and intelligence function within Public Health
England
• Evidence, measurement and reporting
– PHOF – building the inequalities focus
– National tools and resources
– Local data and intelligence
– Developing new sources of intelligence
– Access to the best evidence
• What else?
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
3
Public Health Outcomes Framework
To improve and protect the nation’s health and wellbeing and improve the health of the poorest, fastest
Outcome 1)
Increased healthy life expectancy – taking
into account health quality as well as length of life
1
Improving the wider
determinants of health
2
Health improvement
Outcome 2)
Reduced differences in life expectancy between
communities (through greater improvements in more
disadvantaged communities)
3
Health protection
4
Healthcare and public
health preventing
premature mortality
19 indicators, including:
24 indicators, including:
7 indicators, including:
16 indicators, including:
• Children in poverty
• People with mental
illness or disability in
settled accommodation
• Sickness absence rate
• Statutory
homelessness
• Fuel poverty
• Excess weight
• Smoking prevalence
• Alcohol-related
admissions to hospital
• Cancer screening
coverage
• Recorded diabetes
• Self-reported wellbeing
• Air pollution
• Population vaccination
coverage
• People presenting with
HIV at a late stage of
infection
• Treatment completion
for tuberculosis
• Infant mortality
• Mortality from causes
considered preventable
• Mortality from cancer
• Suicide
• Preventable sight loss
• Excess winter deaths
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
Wicked problems:
Health inequalities
Age
100
90
80
Life expectancy
70
60
Disability-free life expectancy
50
40
30
20
10
0
Most deprived
Least deprived
Neighbourhood income deprivation
Life expectancy and healthy life expectancy, and premature mortality
rates vary across the country – higher rates strongly linked to
socioeconomic deprivation
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
Comparing nationally
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31
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28deaths
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11 deaths
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deaths
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2 Child
Stays
21 Diabetes
4Poverty
for
GCSE
20
alcohol
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13
misuse
<18
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15 Physically
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deaths
&
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Incidence
active
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9stays
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for
23stays
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for
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Road injuries and deaths
Life expectancy - female
Early deaths: heart disease and stroke
Life expectancy - male
Smoking in pregnancy
Smoking related deaths
Long term unemployment
Early deaths: cancer
Adults smoking
Infant deaths
Teenage pregnancy (under 18)
Alcohol-specific hospital stays (under 18)
Deprivation
Proportion of children in poverty
People diagnosed with diabetes
GCSE achieved (5A*-C inc. Eng & Maths)
Drug misuse
Excess winter deaths
Increasing and higher risk drinking
Physically active adults
Hip fracure in 65s and over
Hospital stays for self-harm
Incidence of malignant melanoma
Hospital stays for alcohol related harm
Obese Children (Year 6)
Statutory homelessness
Acute sexually transmitted infections
New cases of tuberculosis
Violent crime
Region:
Compared
with :
Kingston upon Hull UA
North East Lincolnshire UA
Doncaster MCD
Barnsley MCD
Wakefield MCD
Bradford MCD
Rotherham MCD
Leeds MCD
Calderdale MCD
North Lincolnshire UA
Kirklees MCD
Sheffield MCD
Scarborough CD
East Riding of Yorkshire UA
Richmondshire CD
Selby CD
Ryedale CD
Hambleton CD
Craven CD
Harrogate CD
York UA
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Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
7
Comparing regionally
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
8
Comparing with Peers
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Burnley CD
Rochdale MCD
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Manchester MCD
Oldham MCD
Birmingham MCD
Walsall MCD
Wolverhampton MCD
Bolton MCD
Coventry MCD
Blackburn with Darwen UA
Barking and Dagenham LB
Derby UA
Preston CD
Bradford MCD
Pendle CD
Hyndburn CD
Leicester UA
Calderdale MCD
Kirklees MCD
2 26 LE
1 Deprivation
male
27 LE
30female
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19 Hospital
2deaths
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29 Smoking
11
Poverty
stays
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20 Drug
for
22pregnancy
related
TB
alcohol
8misuse
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31 deaths
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6deaths
Unemployment
21 Diabetes
28
eating
cancer
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7adults
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deaths
15 Physically
9stays
Obese
12
in Adults
pregnancy
for
5 Violent
children
active
self-harm
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smoking
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adults
13Stays
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fractures
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forExcess
3alcohol
Stat
STIs
&
32higher
Homelessness
Road
winter
17<18
Incidence
injuries
risk
deaths
dri &
ofdeaths
melanoma
Life expectancy - male
Deprivation
Life expectancy - female
Early deaths: heart disease and stroke
Hospital stays for alcohol related harm
Proportion of children in poverty
Smoking related deaths
Teenage pregnancy (under 18)
Drug misuse
New cases of tuberculosis
Starting breast feeding
Early deaths: cancer
Healthy eating adults
Long term unemployment
People diagnosed with diabetes
Infant deaths
Hospital stays for self-harm
Smoking in pregnancy
Physically active adults
Obese Children (Year 6)
Adults smoking
Violent crime
GCSE achieved (5A*-C inc. Eng & Maths)
Obese adults
Alcohol-specific hospital stays (under 18)
Hip fracure in 65s and over
Increasing and higher risk drinking
Acute sexually transmitted infections
Excess winter deaths
Statutory homelessness
Road injuries and deaths
Incidence of malignant melanoma
ONS Cluster:
Compared with : England
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Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
9
Health inequalities within Bradford
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
Showing the inequalities in life expectancy in
years, for 2006-10
The gap between
10% of the North
population
York the most and least deprived
10.2
Yorkshire by local authority
Males
65
70
75
80
Kingston upon Hull
85
70
Barnsley
9.9
Bradford
Bradford
12.3
Rotherham
Doncaster
10.2
Wakefield
Wakefield
10.6
Kirklees
Kirklees
11.1
Doncaster
11.6
Leeds
10.2
65
70
75
80
8.9
8.0
5.0
7.6
9.1
Sheffield
8.2
Leeds
8.6
5.2
York
7.6
York
6.2
East Riding of Yorkshire
7.2
North Yorkshire
8.8
Calderdale
10.0
East Riding of Yorkshire
7.8
10.7
10.0
Sheffield
90
North Lincolnshire
12.1
North Lincolnshire
85
8.5
North East Lincolnshire
9.7
Calderdale
80
Barnsley
10.0
Rotherham
75
Kingston upon Hull
9.6
North East Lincolnshire
Females
5.6
3.6
North Yorkshire
85
5.6
70
75
80
85
90
Average life expectancy
Most deprived 10%
Least deprived 10% Gap in years
Source: PHE Life Expectancy at Birth by Deprivation Deciles. ONS death registration data and mid-year population estimates & Department for
Communities and Local Government, Indices of Deprivation 2010
Produced by
Presentation title - edit in Header and Footer
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
11
Data tools and resources from PHE
• PHOF
http://www.phoutcomes.info/
• Longer Lives
http://longerlives.phe.org.uk/
• Local Health
www.localhealth.org.uk
• Health Profiles http://www.healthprofiles.info/
• Data Portal
http://datagateway.phe.org.uk/
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
12
Session Plan
• Knowledge and intelligence function within Public Health
England
• Evidence, measurement and reporting
– PHOF – building the inequalities focus
– National tools and resources
– Local data and intelligence
– Developing new sources of intelligence
– Access to the best evidence
• What else?
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
13
Session Plan
• Knowledge and intelligence function within Public Health
England
• Evidence, measurement and reporting
– PHOF – building the inequalities focus
– National tools and resources
– Local data and intelligence
– Developing new sources of intelligence
– Access to the best evidence
• What else?
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
14
Developing a deeper understanding of local
health inequalities – rapid review pilots in Y&H
•
Improving and adding to the Joint Strategic Needs Assessment process locally
•
Voluntary sector focus, barometer on current issues around poverty and health
•
Collaboration between VS organisations, LA PH team, Involve Y&H
•
Two pilots
– Sheffield – Food banks
• Interviews with local providers,
– Wakefield - Pressured parents - workshop with four Wakefield Voluntary
Organisations
•
Some emerging messages:
– Better co-ordination and integration of services
– Opportunity to support and deliver cross- cutting programmes to most deprived
communities
– Importance of pathways to universal services
– Potential rich source of intelligence
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
15
Health Equity North
•
New effort to confront north-south divide
•
3 October, 2013 | By Kaye Wiggins
•
England’s public health body is preparing to “make noise” about the northsouth divide in health outcomes.
•
The Public Health England initiative could extend to taking ministers to task
over their approaches to welfare and employment policies, as they are often
strongly linked to health.
•
The new approach is expected to include academic research and the
creation of a “commission on health equity” and a range of expert groups
formed from key public health figures in the North of England.
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
Reducing Health Inequalities in Bradford
and Airedale Districts
Knowledge and Intelligence from
Public Health England
20 November 2013
Jake Abbas, Associate Director
Northern and Yorkshire Knowledge and Intelligence Team
PHE
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
17