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1Produced 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
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.”
3Produced 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
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 – takinginto account health quality as well as length of life
Outcome 2)Reduced differences in life expectancy betweencommunities (through greater improvements in moredisadvantaged communities)
Improving the wider determinants of health1
19 indicators, including:
• Children in poverty• People with mental
illness or disability in settled accommodation
• Sickness absence rate• Statutory
homelessness• Fuel poverty
Health improvement2
24 indicators, including:
• Excess weight• Smoking prevalence• Alcohol-related
admissions to hospital• Cancer screening
coverage• Recorded diabetes• Self-reported wellbeing
Health protection3
7 indicators, including:
• Air pollution• Population vaccination
coverage• People presenting
with HIV at a late stage of infection
• Treatment completion for tuberculosis
Healthcare and publichealth preventingpremature mortality
4
16 indicators, including:
• 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
Life expectancy and healthy life expectancy, and premature mortality rates vary across the country – higher rates strongly linked to socioeconomic deprivation
7Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
Comparing nationallyRegion: 3 16 Obese adults14 Healthy eating adults8 Breastfeeding32 Road injuries & deaths27 LE female30 Early deaths HD&S26 LE male7 Smoking in pregnancy29 Smoking related deaths6 Unemployment31 Early deaths cancer12 Adults smoking28 Infant deaths11 Teen pregnancy10 Hosp. Stays for alcohol <181 Deprivation2 Child Poverty21 Diabetes4 GCSE20 Drug misuse25 Excess winter deaths13 Increasing & higher risk dri15 Physically active adults24 Hip fractures18 Hospital stays for self-harm17 Incidence of melanoma19 Hospital stays for alcohol9 Obese children3 Stat Homelessness23 Acute STIs22 TB5 Violent CrimeCompared with :
1
Obe
se a
dults
Heal
thy
eatin
g ad
ults
Star
ting
brea
st fe
edin
gRo
ad in
jurie
s and
dea
ths
Life
expe
ctan
cy -
fem
ale
Early
dea
ths:
hea
rt d
iseas
e an
d st
roke
Life
expe
ctan
cy -
mal
eSm
okin
g in
pre
gnan
cySm
okin
g re
late
d de
aths
Long
term
une
mpl
oym
ent
Early
dea
ths:
canc
erAd
ults
smok
ing
Infa
nt d
eath
sTe
enag
e pr
egna
ncy
(und
er 1
8)Al
coho
l-spe
cific h
ospi
tal s
tays
(und
er 1
8)De
priv
ation
Prop
ortio
n of
child
ren
in p
over
tyPe
ople
dia
gnos
ed w
ith d
iabe
tes
GCSE
ach
ieve
d (5
A*-C
inc.
Eng
& M
aths
)Dr
ug m
isuse
Exce
ss w
inte
r dea
ths
Incr
easin
g an
d hi
gher
risk
drin
king
Phys
ically
acti
ve a
dults
Hip
frac
ure
in 6
5s a
nd o
ver
Hosp
ital s
tays
for s
elf-
harm
Incid
ence
of m
alig
nant
mel
anom
aHo
spita
l sta
ys fo
r alco
hol r
elat
ed h
arm
Obe
se C
hild
ren
(Yea
r 6)
Stat
utor
y ho
mel
essn
ess
Acut
e se
xual
ly tr
ansm
itted
infe
ction
sN
ew ca
ses o
f tub
ercu
losis
Viol
ent c
rime
00FA Kingston upon Hull UA R R R A R R R R R R R R A R R R R R R R R A R R R G R R R A G R00FC North East Lincolnshire UA R R R R R R R R R R A R A R A R R R A R A A A A R G R A A A G R00CE Doncaster MCD R R R R R R R R R R R R A R A R R R R R A A A A A A R A G A G G00CC Barnsley MCD R R R G R R R R R R R R A R R R R R R R A A R A A A R A G G G G00DB Wakefield MCD R R R R R R R R R R R R A R R R R R A R A A A A R A G A G G G G00CX Bradford MCD R R R A R R R R R R A A R A G R R R R R A A R G R G R R G G R G00CF Rotherham MCD R R R G R R R NA R R R R A R A R R R A R A A A A A A R A G R G G00DA Leeds MCD R R R A R R R A R R R R A R A R R G R R A A G A R A A A G R A G00CY Calderdale MCD R R G R R R R G R R R A R R R R R G G A A A R A R A R A G G A G00FD North Lincolnshire UA R R R R R A A R R R R R A R G G A R R R A A A A G G R A G G A A00CZ Kirklees MCD R R R G R R R A R R A R A R A R G R G A A A A A R A G A G A R G00CG Sheffi eld MCD A R G G R R R A R R R A A R G R R A R R A A A A G A G A R A A G36UG Scarborough CD A A A R R R R A A R A A A A R A R G R A A A R G A A A G R G G A00FB East Riding of Yorkshire UA R A R R A A G A G G G G A G G G G R R G A A A A G A G G R G G G36UE Richmondshire CD A A A R A A A A G G A A A G A G G G G G A A A A G A G G R G G G36UH Selby CD R A A R G G A A A G A G A G A G G A G G A A A A G A G A G G G G36UF Ryedale CD A A A R A A G A A G G A A G G G G G A G A A G A G A G A G G G G36UC Hambleton CD A A A R G G G A G G G A A G A G G G A G A A G A G A G A R G G G36UB Craven CD A A A R G G G A G G G G A G A G G A G G G A A A A A G G G G A G36UD Harrogate CD G A A R G G G A G G G G A G R G G G G G A A A A A R G G G G G G00FF York UA A A A G A G A A G G A G A G A G G G G G A A G A A A G G G G G G
8Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
Comparing regionally
9Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
Comparing with PeersONS Cluster: 2 26 LE male1 Deprivation27 LE female30 Early deaths HD&S19 Hospital stays for alcohol2 Child Poverty29 Smoking related deaths11 Teen pregnancy20 Drug misuse22 TB8 Breastfeeding31 Early deaths cancer14 Healthy eating adults6 Unemployment21 Diabetes28 Infant deaths18 Hospital stays for self-harm7 Smoking in pregnancy15 Physically active adults9 Obese children12 Adults smoking5 Violent Crime4 GCSE16 Obese adults10 Hosp. Stays for alcohol <1824 Hip fractures13 Increasing & higher risk dri23 Acute STIs25 Excess winter deaths3 Stat Homelessness32 Road injuries & deaths17 Incidence of melanomaCompared with : England
Life
expe
ctan
cy -
mal
eDe
priv
ation
Life
expe
ctan
cy -
fem
ale
Early
dea
ths:
hea
rt d
iseas
e an
d st
roke
Hosp
ital s
tays
for a
lcoho
l rel
ated
har
mPr
opor
tion
of ch
ildre
n in
pov
erty
Smok
ing
rela
ted
deat
hsTe
enag
e pr
egna
ncy
(und
er 1
8)Dr
ug m
isuse
New
case
s of t
uber
culo
sisSt
artin
g br
east
feed
ing
Early
dea
ths:
canc
erHe
alth
y ea
ting
adul
tsLo
ng te
rm u
nem
ploy
men
tPe
ople
dia
gnos
ed w
ith d
iabe
tes
Infa
nt d
eath
sHo
spita
l sta
ys fo
r sel
f-ha
rmSm
okin
g in
pre
gnan
cyPh
ysica
lly a
ctive
adu
ltsO
bese
Chi
ldre
n (Y
ear 6
)Ad
ults
smok
ing
Viol
ent c
rime
GCSE
ach
ieve
d (5
A*-C
inc.
Eng
& M
aths
)O
bese
adu
ltsAl
coho
l-spe
cific h
ospi
tal s
tays
(und
er 1
8)Hi
p fr
acur
e in
65s
and
ove
rIn
crea
sing
and
high
er ri
sk d
rinki
ngAc
ute
sexu
ally
tran
smitt
ed in
fecti
ons
Exce
ss w
inte
r dea
ths
Stat
utor
y ho
mel
essn
ess
Road
inju
ries a
nd d
eath
sIn
ciden
ce o
f mal
igna
nt m
elan
oma
00CS Sandwell MCD R R R R R R R R R R R R R R R R R R R R R G R R R R A G A R G G30UD Burnley CD R R R R R R R R R A R R R R R R R R A R A R R A R A A A A A R A00BQ Rochdale MCD R R R R R R R R R R R R R R R A R R A R R R R A R A A G A A G A00FY Nottingham UA R R R R R R R R R R R R A R G R R R A R R R R G G R A R A R R G00BN Manchester MCD R R R R R R R R R R NA R A R G R R R A R R R R G R R A R A R G G00BP Oldham MCD R R R R R R R R R A R R R R R R R R R A R R R R R A A G A G G G00CN Birmingham MCD R R R R R R R R R R R R R R R R R G R R A R G R G A A R A R A G00CU Walsall MCD R R R R R R R R R R R R R R R R G R R R R A R R A A A R A G G G00CW Wolverhampton MCD R R R R R R R R R R R R R R R R G R A R R R R R G A A G A R G G00BL Bolton MCD R R R R R R R R R R R A R R R A A R A R R R A A R A A A A A G G00CQ Coventry MCD R R R A R R A R R R A R A R A A R A R R A R A R R A A R A R G G00EX Blackburn with Darwen UA R R R R R R R A R R R A R A R R R R R A R R A A A A A G A G A A00AB Barking and Dagenham LB R R R R R R R R A R NA R R R R A G NA R R A R A R G A A R A R G G00FK Derby UA R R A R R R A R R A R A A R R R R R A A A R R A A A A R A G A A30UK Preston CD R R R R R R R R R R R R A G R A R R A G A R G G R R A R A G R A00CX Bradford MCD R R R R R R R A R R R A R R R R R R R R A G R R G G A G A G A G30UJ Pendle CD R R R R R R R R R R R A A G R R R R R A A G R A R A A G G G A A30UG Hyndburn CD R R R R R R R R R A R R A G R A R R R A A A A A R G A G A G A A00FN Leicester UA R R R R R R A A R R A A R R R R G G R A A R R A A A A R A G G G00CY Calderdale MCD R R R R R R R R A A G R R R G R R G R A A G G R R A A G A G R A00CZ Kirklees MCD R R R R G G R R A R R A R R R A R A A A R G G R A A A A A G G A
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
Health inequalities within Bradford
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
Most deprived 10% Least deprived 10% Gap in years
Average life expectancy
Males Females
10.2
65 70 75 80 85
York 5.6
70 75 80 85 90
North Yorkshire
10.2
7.6
7.2
10.0
10.0
12.1
11.6
9.7
11.1
10.6
10.2
12.3
9.9
10.0
9.6
65 70 75 80 85
York
North Yorkshire
East Riding of Yorkshire
Sheffield
North Lincolnshire
Leeds
Calderdale
Rotherham
Kirklees
Wakefield
Doncaster
Bradford
Barnsley
North East Lincolnshire
Kingston upon Hull
5.6
3.6
5.2
8.6
8.2
9.1
10.7
7.6
5.0
8.0
8.9
6.2
8.8
7.8
8.5
70 75 80 85 90
North Yorkshire
York
East Riding of Yorkshire
Leeds
Sheffield
Calderdale
North Lincolnshire
North East Lincolnshire
Doncaster
Kirklees
Wakefield
Rotherham
Bradford
Barnsley
Kingston upon Hull
11Presentation title - edit in Header and Footer
Showing the inequalities in life expectancy in years, for 2006-10
The gap between the most and least deprived 10% of the population by local authority
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
12Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
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/
13Produced 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?
14Produced 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?
15Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme
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
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 north-south 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.
17Produced 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