Geographies and populations Where are the boundaries? Paul Norman School of Geography University of Leeds [email protected]Acknowledgements • ESRC ONS GROS NISRA OS UKBORDERS CDU ESDS • ESRC Research Awards RES-165-25-0032, RES-189- 25-0162 NHS Information Centre, 21st March 2011
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Geographies and populations Where are the boundaries? Paul Norman School of Geography University of Leeds [email protected] Acknowledgements ESRC.
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• ESRC Research Awards RES-165-25-0032, RES-189-25-0162
NHS Information Centre, 21st March 2011
Geographies and populations
• What is a ‘geography’? How are geographies defined?• What is a population? How are they defined?• Health measures by areas and by population subgroups• What else do geographers do with health data?
• Challenges of time-series analysis: changing boundaries and population definitions
• What geography & which population?• Aspects of the DH White Paper
No ward stays exactly the same during the period(East is almost the same though)
Tricky due to boundary change …
Peterborough: 1988 - 2005
What about change over time?
1991 1999
2004
Soon …All change please!
“The redisorganisation of the NHS”Smith J, Walshe K, Hunter D (2001) BMJ: 323: 1262-3
• Administrative boundary change: due to
– Need for good governance (re-organise subnational structure of
administrative geography) &
– Differential population change by small areas & need for equity in
electoral representation
• Census boundary change: due to
– Many census geographies aligned with administrative geographies
(as above) &
– Need for a local geography which protects confidentiality yet
delivers usable statistics, & thus may be time point specific
• Lead to boundaries being re-drawn
– But this severely hampers comparison of cross-sections
– Census & other applications may need consistent geographical
areas over time for analysis of change
Why do boundaries change?
Time-series: infant mortality rates
1981 1986 1991 1996 2001 2006
0
5
10
15
20
25
1970-72 1980-82 1990-92 2000-02 2004-06
Infa
nt
Mo
rta
lity
Ra
te
Q1: least deprived Q2 Q3 Q4 Q5: most deprived
0.50
0.75
1.00
1.25
1.50
1980 1985 1990 1995 2000 2005
Infa
nt
Mo
rtal
ity
Rat
ios
Cities and Services London Suburbs London Centre
London Cosmopolitan Prospering UK Coastal and Countryside
Mining and Manufacturing
IMR relative to national rate
Deprivation Supergroups
What about change over time?1991 Ethnic groups
2001 Ethnic groups
Social Class to NS-SEC
Why (not) change? Administrative, census & survey data, etc• Historical record versus contemporary relevance?• Continuity versus current applicability? • Reactive versus proactive?
‘Healthy Lives, Health People: Our Strategy for public health in England’
Geographical & population aspects to be resolved• Life expectancy between the richest and poorest neighbourhoods (p.16)• One ward in Kensington and Chelsea … compared with … one of the capital’s poorer wards (p.15)• Neighbourhood income level (p.16)• Data will be published to make it easier for local communities to compare themselves with others across the country (p.26) • Department for Communities and Local Government will support local areas with streamlined planning policy that aligns social, economic, environmental and health priorities into one place (p.40)• GP consortia will have responsibility for the whole population in their area (p.62)
Community? Neighbourhood?
Indian, Pakistani, Bangladeshi
Students
Community? Neighbourhood?
‘Healthy Lives, Health People: Our Strategy for public health in England’
Community? Neighbourhood?
Anne Milton, Under Secretary of State for Public Health 11/01/2011
“We generally take a lead from the Office for National Statistics and use Super Output areas (lower and/or middle layer) for small area analysis”
“Terms such as, for example, communities or neighbourhoods referred to in publications should be interpreted as plain English terms that in analysis would be represented by an appropriate standard geography”
‘Healthy Lives, Health People: Our Strategy for public health in England’
GP consortia?• p.62 GP consortia will have responsibility for the whole population in their area
Anne Milton Under Secretary of State for Public Health 11/01/2011
“The White Paper makes clear that GP consortia will have to have an area of geographical focus. Work on this is still ongoing but it is likely that this will be based on existing standard geographies”
‘Healthy Lives, Health People: Our Strategy for public health in England’
GP consortia? Likely to be within a local authoritybut #1 … Edge effects & wider catchment
‘Healthy Lives, Health People: Our Strategy for public health in England’
GP consortia? Likely to be within a local authoritybut #2 … People are different & from different areas
Geographies and populationsWhere are the boundaries?
Need consistency over time: geographies & populationsNeed also to have contemporary / ongoing relevanceGood policy decisions & appraisals of success need to be underpinned by good data
“Data will be published to make it easier for local communities to compare themselves with others across the country”“Local areas with streamlined planning policy that aligns social, economic, environmental and health priorities into one place”
Needs• Global shift by data providers: a ‘can do’ attitude• Georeferencing: e.g. postcode > OA > SOA linkages• Back revisions of existing datasets• 2021 Census & / or a real replacement