Introducing the LHO

Dr Bobbie Jacobson

Director

www.lho.org.uk

LHO lead areas:Health inequalitiesEthnicitySmokingNICE

APHO: The Observatory Network and Lead Areas

LHO –What do we do?• We work in partnership to turn health data into

intelligence to support decision-making on commissioning health and health care

• We monitor, forecast and assess the impacts of health policy in London

• We are a hub for signposting health intelligence and develop innovative methods for sharing/managing that knowledge.

• We work with APHO and researchers to produce national e-tools, reports and advice to support local action

• We help build analytic capacity in London’s workforce

Collating/ Processing Data

Turning Data into Health

Intelligence

Collecting Data/ Information

Using Health Intelligence To

Improve Health & Care

Other Agencies

Public Health Observatory role

Role of PHOs in health intelligence

Travelling east from Westminster, each tube stop represents nearly one year of life expectancy lost

Westminster

Waterloo

Southwark

London Bridge

BermondseyCanada

Water

CanaryWharf

NorthGreenwich

Canning Town

London Underground Jubilee Line

Differences in Life Expectancy within a small area in London

Electoral wards just a few miles apart geographically have lifeexpectancy spans varying by years. For instance, there are eight stops between Westminster and Canning Townon the Jubilee Line – so as one travels east, each stop, onaverage, marks nearly a year of shortened lifespan. 1

River Thames

1 Source: Analysis by London Health Observatory using Office for National Statistics data. Diagram produced by Department of Health

Male Life Expectancy71.6 (CI 69.9-73.3)

Female Life Expectancy 80.6 (CI 78.7-82.5)

Male LifeExpectancy77.7 (CI 75.6-79.7)

Female Life Expectancy84.2 (CI 81.7-86.6)

What Range of work does LHO do?

One stop Query desk/freeweb access to intelligence

Tools and methods

Supporting Health PractitionersInequalities Intervention toolPractice profilesBasket of Indicators

Comparative

analysis/interpretation

Public Health Advocacy

RESPONSIVE PRO-ACTIVE

-Monitoring Public health Performance-community health profiles-Commissioning for Equity Series

The LHO rolling business plan 2008/9:

– Core programme• Strategic health intelligence projects to support

local decision-making in London • Responsive enquiry service • Health intelligence support to APHO National

Programmes

– Externally commissioned programme• Bespoke health intelligence projects

commissioned directly from LHO by local and national agencies

Examples of Recent LHO Work

• Local authority health Profiles 2008

• The Health Inequalities Intervention Tool

• World Class Healthcare in London Briefings (“Stroke” and “Mind the Gap!”)

Local authority Health profiles 2008

• 32 indicators profiling comparative health in 386 English local authorities

• Produced by APHO annually for DH• Easily accessible via an interactive

webtool www.healthprofiles.info• Information on trends, health

inequalities, benchmarking at LA level and below.

Barking and Dagenham’s Health Profile

Barking and Dagenham’s Health Profile

What is the Health Inequalities intervention tool?

• Planning tool to help PCTs and LAs with local delivery planning and commissioning to reduce inequalities in life expectancy

• Commissioned by Department of Health and produced by LHO and YHPHO for APHO

What does the tool do?• Quantifies the current life expectancy gap

at birth within local authority areas, and between spearhead local authorities and England

• Quantifies the diseases contributing to the life expectancy gap

• Model the effect of four high impact interventions on closing the life expectancy gap

Why use the tool?• There are inequalities in life expectancy within all local areas – spearhead and non-spearhead

• Examples of life expectancy gap between Most Deprived Quintile and Local Authority as a whole in London:– Bromley (non-spearhead) – 4 year difference, 5% gap

(males)– Lewisham (spearhead) – 3 year difference, 4.5% gap

(males)

Understanding the gap• Variation in the main diseases which make up the within LA

gap across the country• Key diseases making up the gap in males in two egs (Most

Deprived Quintile compared to Least Deprived Quintile):

Bromley (non-spearhead)

Lewisham (spearhead)

CHD (coronary heart disease) CHD

Lung cancer Stroke

COPD (chronic obstructive pulmonary disease)

Other CVD

Other CVD (cardiovascular disease)

Other cancers

If females in the most deprived quintile had the same mortality rate from stroke as females in the least deprived quintile, they would live 0.5 years longer

Applying evidence- based measures to show impact on the gap

• Interventions included:• Increasing smoking quitters• Improving blood pressure control in people without

diagnosed CVD• Improving blood cholesterol control in people without

diagnosed CVD• Reducing infant mortality

• Modelling of two scenarios:• Applying the interventions across the LA as a whole• Focusing the interventions in the MDQ(Most Deprived

Quintile)

Applying the interventions in the Most Deprived Qunitile(MDQ)

• Chart shows the reduction in the within area life expectancy gap in males in Lewisham if the following interventions are applied

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

2000 smoking quitters Smoking quitters + 2000hypertensives treated

Smoking quitters + 2000hypertensives treated + with

statin

1 intervention Combination of interventions

% r

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in li

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xpec

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Want to know more?

www.lho.org.uk

• Local health profiles: www.healthprofiles.info

• Health inequalities intervention tool: http://www.lho.org.uk/HEALTH_INEQUALITIES/Health_Inequalities_Tool.aspx