The Work of the Public Health Observatories

Dr Bobbie JacobsonDirector, London Health Observatory

www.lho.org.uk

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”

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

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

The Public Health Observatories: Pivotal Role In

Public Health Intelligence?

R&D PractitionersLHO

DH andgovernment

policy

RegionalGovernment

RegionalSurveillance

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)

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

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

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.”

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.

Life Expectancy at Birth in London 2001Male Female

Life Expectancy in London by Deprivation Quintile (1997-9)Source: “Mapping Inequalities in Health Across London”, LHO

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Geographic Inequalities in Infant Mortality in London by Borough

1999-2001Source: “Health In London Report”, forthcoming

Infant Mortality by Index of Deprivation

Source: “Health In London report”, forthcoming

R2 = 0.4273

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Index of deprivation - index of ward scores

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Infant mortality rates by social class and registration type 1993-99

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Target groups

Specific infant mortality rates by registration type, London 1993-99

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Infant mortality rates by mothers birthweight and registration type,

London 1993-99

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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