Produced by PHE Knowledge & Intelligence Team – Northern and Yorkshire: Local Health Intelligence Solutions Programme Reducing Health Inequalities in Bradford.

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


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


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


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


• Excess weight• Smoking prevalence• Alcohol-related

admissions to hospital• Cancer screening

coverage• Recorded diabetes• Self-reported wellbeing

Health protection3


• 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


• Infant mortality• Mortality from causes

considered preventable• Mortality from cancer• Suicide• Preventable sight loss• Excess winter deaths

Produced by


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


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


Comparing regionally

9Produced by


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


Health inequalities within Bradford

Produced by


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


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/

http://www.phoutcomes.info/



http://longerlives.phe.org.uk/



http://www.localhealth.org.uk/

http://www.healthprofiles.info/

http://www.healthprofiles.info/

http://datagateway.phe.org.uk/



13Produced by


Session Plan



• What else?

14Produced by


Session Plan



• What else?

15Produced by


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


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


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 Reducing Health Inequalities in Bradford.

Documents

intelligence team phe

intelligence function

nations health

yorkshire knowledge

account health quality

wider determinants of

public health england

local government