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Trutz Haase THE IRISH DEPRIVATION MEASURES Applications and Outlook Revision, June 2012 Slide 2 KEY AREAS OF APPLICATION Local Area Initiatives Health Education Environment National Development Programme Statistical Methods Slide 3 LOCAL COMMUNITY DEVELOPMENT PROGRAMME Local Area Initiatives Local Community Development Programme RAPID Childcare Initiatives Family Resource Centres County Development Plans Health Education Environment National Development Programme Statistical Methods Originally designation of most disadvantaged areas under the PESP 2008 cohesion (amalgamation of LDSIP with LEADER) and alignment with LA boundaries Now emphasis on delivering actions to most disadvantaged communities within each LA http://maps.pobal.ie/#/map Slide 4 RAPID Local Area Initiatives Local Community Development Programme RAPID Childcare Initiatives Family Resource Centres County Development Plans Health Education Environment National Development Programme Statistical Methods Originally designated on basis of ED-level deprivation scores Then combination of EDs and EAs Now designation using new SAs Slide 5 RAPID Local Area Initiatives Local Community Development Programme RAPID Childcare Initiatives Family Resource Centres County Development Plans Health Education Environment National Development Programme Statistical Methods Designation at below 1 STD (deprivation score below -10 = disadvantaged) Slide 6 CHILDCARE INITIATIVES Local Area Initiatives Local Community Development Programme RAPID Childcare Initiatives Family Resource Centres County Development Plans Health Education Environment National Development Programme Statistical Methods Mapping out of almost 4,400 childcare initiatives across the country Targeting of childcare supports towards most disadvantaged communities Slide 7 FAMILY RESOURCE CENTRES Local Area Initiatives Local Community Development Programme RAPID Childcare Initiatives Family Resource Centres County Development Plans Health Education Environment National Development Programme Statistical Methods 107 Family Resource Centres (FRCs) throughout Ireland Supported through Family Support Agency Aimed at supporting disadvantaged communities Slide 8 COUNTY DEVELOPMENT PLANS Local Area Initiatives Local Community Development Programme RAPID Childcare Initiatives Family Resource Centres County Development Plans Health Education Environment National Development Programme Statistical Methods Only 10 years ago, most county development plans where exclusively dealing with the built environment Now designated chapters on population in most county development plans Generally making explicit reference to Irish deprivation measures Slide 9 LOCAL AREA INITIATIVES IN COMPARISON, 1991-2006 Local Area Initiatives Local Community Development Programme RAPID Childcare Initiatives Family Resource Centres County Development Plans Health Education Environment National Development Programme Statistical Methods Slide 10 HSE FACT FILE Local Area Initiatives Health HSE Fact File Epidemiological studies Health Inequalities Primary Health Care Teams Education Environment National Development Programme Statistical Methods http://www.hse.ie/eng/staff/Resources/FactFile/Health_Status_Reports/Louth_Health_Status_Report/Deprivationhttp://www.hse.ie/eng/staff/Resources/FactFile/Health_Status_Reports/Louth_Health_Status_Report/Deprivation/ Slide 11 EPIDEMIOLOGICAL STUDIES Local Area Initiatives Health HSE Fact File Epidemiological studies Health Inequalities Primary Health Care Teams Education Environment National Development Programme Statistical Methods Mortality Differentials http://www.cso.ie/en/media/csoie/census/documents/Mortality_Differentials_in_Ireland.pdf Slide 12 EPIDEMIOLOGICAL STUDIES Local Area Initiatives Health HSE Fact File Epidemiological studies Health Inequalities Primary Health Care Teams Education Environment National Development Programme Statistical Methods High blood pressure Angina, heart attack Stroke Diabetes http://www.publichealth.ie/sites/default/files/documents/files/Making%20Chronic%20Conditions.pdf Slide 13 HEALTH INEQUALITIES Local Area Initiatives Health Epidemiological studies Health Inequalities Primary Health Care Teams Education Environment National Development Programme Statistical Methods Slide 14 PRIMARY HEALTH CARE TEAMS Local Area Initiatives Health Epidemiological studies Health Inequalities Primary Health Care Teams Education Environment National Development Programme Statistical Methods http://www.hrb.ie/publications/hrb-publication/publications//511// Slide 15 HIGHER EDUCATION ACCESS ROUTES Local Area Initiatives Health Education Higher Education Access Routes Educational Disadvantage Growing-up in Ireland Environment National Development Programme Statistical Methods http://www.accesscollege.ie/hear/indicators-area.php Slide 16 EDUCATIONAL DISADVANTAGE Local Area Initiatives Health Education Higher Education Access Routes Educational Disadvantage Growing-up in Ireland Environment National Development Programme Statistical Methods The Department for Education (UK) calculates the level of school deprivation from the numbers of children living in families in each Lower Super Output Area (LSOA) who receive tax credits. However, as below figures show, not taking into account the selective nature of school intakes may lead to misleading specification. http://www.significancemagazine.org/details/webexclusive/1311633/School-funding-and-deprivation.html Slide 17 GROWING-UP IN IRELAND Local Area Initiatives Health Education Higher Education Access Routes Educational Disadvantage Growing-up in Ireland Environment National Development Programme Statistical Methods Significant Influences on Child and Parental Well-being Pratschke, Haase and McKeown, 2011 http://trutzhaase.eu/wp/wp-content/uploads/R-2011-Well-being-and-the-Family-System.ppt Slide 18 ENVIRONMENTAL IMPACT ASSESSMENT Local Area Initiatives Health Education Environment Environmental Impact Assessment National Transport Planning National Development Programme Statistical Methods We found a clear socioeconomic gradient in respiratory disease mortality (Fig. 2). At each level of PM10 exposure, risk of respiratory disease mortality increased with increasing socioeconomic deprivation, after control for relevant individual- and area-level covariates. We found significant inequality, with the most deprived CAUs having over 1.7 times the risk of respiratory disease mortality than the most affluent areas. Is particulate air pollution associated with health and health inequalities in New Zealand? Richardsona, Pearcea and Kinghamb, 2011 Slide 19 NATIONAL TRANSPORT PLANNING Local Area Initiatives Health Education Environment Environmental Impact Assessment National Transport Planning National Development Programme Statistical Methods Waterford Rosslare Europort Route Business Case for Withdrawal of Rail Services July 2010 Slide 20 GATEWAY DEVELOPMENT INDEX Local Area Initiatives Health Education Environment National Development Programme Gateway Development Index Statistical Methods Slide 21 RESOURCE ALLOCATION MODELS Local Area Initiatives Health Education Environment National Development Programme Statistical Methods Resource Allocation Models Sampling Methodologies for Household Surveys Small Area Estimation A central problem in the health service generally and childrens services in particular is the lack of a Resource Allocation Model (RAM). Having a RAM is important, for it determines what human and financial resources should be allocated and where according to objective criteria designed to meet measured need. Harvey, B. A Way Forward for Delivering Childrens Services, Barnardos, March 2011 The question posed by the study was: Given the national spend on the health services, and existing allocation between services, how should the budget for each service be divided between PCCC areas in order to support access to services in rough proportion to the need for these services in each area?' The current system does not allocate resources in a way that addresses this question. Staines, A. et al. Towards the development of a Resource Allocation Model for Primary, Continuing and Community Care in the Health Services, HRB, 2010 The 2009 Resource Allocation Model introduced a new formula to take account of the extension of the programme which, after the conclusion of the cohesion process, now covers all 32 Local Authority Areas. Given the new unified structures and additional constraints arising from the tighter budgetary situation since the coming to an end of the economic boom, it is now felt that the allocations made under the LCDP should take into account other allocations made to the same areas, specifically those under the LEADER and Local Employment Services (LES) programmes. Haase, T. Technical Note on the 2011 RAM for the LCDP, Pobal, 2011 Slide 22 SAMPLING METHODOLOGIES FOR HOUSEHOLD SURVEYS Local Area Initiatives Health Education Environment National Development Programme Statistical Methods Resource Allocation Models Sampling Methodologies for Household Surveys Small Area Estimation Model Sample Design Relative Standard Error Mean Square Error 95% Confidence Interval EUELLIEDEUELLIEDEUELLIED S8 2SCS1,300x433333333 S9 2SSCS N4A81,300x432323323 S10 2SSCS N3A5D51,300x4221221221 S11 2SSCS N3D101,300x4111211121112 M8 2SCS1,300x20333 M9 2SSCS N4A81,300x20333333333 M10 2SSCS N3A5D51,300x20211221122112 M11 2SSCS N3D101,300x20112112211221 Comparison of Sampling Designs Haase, T. and Pratschke, J. Optimising the Sampling Methodology for CSO Household Surveys, CSO, 2012 Slide 23 SMALL AREA ESTIMATION Local Area Initiatives Health Education Environment National Development Programme Statistical Methods Resource Allocation Models Sampling Methodologies for Household Surveys Small Area Estimation Slide 24