Transcript Document
Tracking the impact on health and well-being in London The developing ‘framework of indicators’ ..a social determinants approach Gail Findlay and Mark Gamsu - Independent Consultants working with UCL IoHE 26th March 2012 Health impacts of an economic downturn • Overall mortality mixed results • Increase in suicides, parasuicides, infectious disease, homicides • Fall in road traffic accidents • Mental health will suffer in the short/med/long-term • Long-term impacts on CV and general mortality • Reduced government spending Impacts of the economic downturn on… • …employment: Increased unemployment, particularly for certain demographics (NEETs, LT unemployed, disabled); impact on working conditions? • …income: Sharp changes because of increased unemployment debt, poverty • …housing: more landlord and mortgage repossessions, homelessness, overcrowding etc. Potential impacts of the welfare reforms on… • …employment: Will the reforms increase the number of people in employment? • …income: Reduced incomes for most people in receipt of benefits • …housing: Changes to LHA and the caps will hit London disproportionately poverty, homelessness, overcrowding, internal migration Population groups likely to be most affected: • People who become unemployed • Those newly out of education – NEET • LT unemployed, disabled, other population groups facing additional barriers to employment • Families with children – particularly lone parents and larger families • People on means-tested benefits • People living in private rented accommodation • People living in certain areas of London Draft criteria • Sensitive to short and medium term change • Sensitive to actual and emerging impacts/direction of travel • Available from routinely collected data – but not necessarily from conventional sources (eg. CVS data) Providing info about impact: • At different geographical levels: neighbourhood to pan London • On existing or emerging vulnerable groups • On inequalities • Potential for modeling/enabling analysis of forward projections/trends Unemployment • • • • • • • • NEETs Unemployment rates (by deprivation, ethnicity and other groups) People losing jobs - new JSA claimants People not getting jobs Long term unemployed Economically inactive People coming off benefit to JSA Nature of vacancies – types of jobs available versus skills in population Quality of Work • Sickness Absence • Number of grievances relating to work place stress/poor health • PAYE: Registered Self Employed • FT/PT working • Duration of employment contracts Income - Poverty • • • • • • Child Poverty Pensioner Poverty Working Age Poverty Number of people on means tested benefits Fuel Poverty Measure Low pay threshold; pay gradient; shifts in profiles of levels of pay; inequality measures/ratios Income - Debt • • • • • • • Number of people in problematic debt Personal insolvency Number of people taking doorstep loans Types of debt - credit card etc Number of people in mortgage arrears Number of people in rent arrears Households in arrears Income - other • Take up of and growth of soup kitchens • Purchasing behaviour in large supermarkets • Housing benefit case load and flows Housing • Overcrowding and other relevant housing‘ conditions’ • Types of tenure in bands of cost • Council and Social Landlord waiting lists; % homes affordable under LAA • • • • • Number of rough sleepers Number of young people not in stable accommodation Temporary Accommodation Utilization Landlord possession orders Local housing availability Health and well-being impact • • • • • • Anti-depressant prescribing Incidence of mental health problems Referrals for CBT Suicide and para-suicide Calls for help - Samaritans Diagnosis of pulmonary TB and ? other infectious diseases? • IB/ ESA claims • Changes to GP lists • Alcohol related A&E admissions? Health and Well-being impact - cont • New well-being index Impact on Communities: • Acquisitive crime • Community profiles: eg numbers of betting shops; pay day lenders; pawn shops; vacant shops/properties Impact on Children: • Readiness for school • ?? QUESTIONS FOR DISCUSSION • Comments on the draft framework • …and on any of the suggested indicators? • Are there any key areas and/ or good indicators missing? • Suggestions for indicators for children specifically? • How can we engage local authorities and promote their use of this indicator framework? • Suggestions of other ‘key players’ we should engage in the development of this framework? For more information and to feed in comments and ideas on the framework Please contact: Gail Findlay [email protected] Tel: 07940 743201 Mark Gamsu [email protected] Tel: 07557 375028