Transcript “Tackling Health Inequalities in London: How the LHO is supporting the NHS” Dr Bobbie Jacobson Director www.lho.org.uk.

“Tackling Health Inequalities in London:
How the LHO is supporting the NHS”
Dr Bobbie Jacobson
Director
www.lho.org.uk
Health Intelligence in London Made Easy:
The LHO's Business
Collecting
Data/ Information
Using Health
Intelligence To
Improve
Health & Care
Collating/
Processing Data
Turning
Data into Health
Intelligence
Public/ Other Sectors
Public Health Observatory role
Aims of the London Health
Observatory
One stop access
to information
/ data
Query desk:
Information and
Data
RESPONSIVE
Tools and methods
for data analysis
Support Public Health
and health
intelligence networks
Comparative
analysis/interpretation
of health related data/
Policy implementation
Communication
and advocacy for
better public
health information
PRO-ACTIVE
The Association of Public Health
Observatories (APHO) - At A Glance
www.pho.org.uk
NATIONAL LEAD AREAS
Eastern Region PHO
www.erpho.org.uk
Primary Care, Methodologies
London LHO
www.lho.org.uk
Health Inequalities, Social Exclusion and Regeneration
North West PHO
www.nwpho.org.uk
Access to Communicable Disease data, Health Protection,
Drug Misuse
North East PHO
www.nepho.org.uk
Mental Health, Prison Health, Children and Young People
South East PHO
www.sepho.org.uk
Coronary Heart Disease & Stroke, Men’s Health
East Midlands PHO
www.empho.org.uk
Teenage Pregnancy
West Midlands PHO
www.wmpho.org.uk
Cancers, Older People, Environment
South West PHO
www.swpho.org.uk
Accident Prevention, Sexual Health
Yorkshire & Humber PHO
www.yhpho.org.uk
Diabetes
LHO Work Programmes 2003/04
“At a Glance”
Work Programme
Funding
Network Development & Communications
Core DoH/RDPH
Website Information & Development
Core DoH/RDPH
Access to Routine Data
Core DoH/RDPH
SKIL - Sharing Knowledge in London Non-Routine Data/Information Access
Core DoH + R&D
Drugs & Health Intelligence Programme
National Treatment Agency
PCT Information programme
PCT London
Health Impact Assessment
RDPH and charges
“Diversity Counts”: London's Ethnic Health
Intelligence Programme
Core DoH/RDPH
Tackling Health Inequalities
Core DoH/RDPH, GLA, CHI
Mental Health
London Regional Development
Centre for Mental Health
National/International work
DoH/EU
LHO’s Health Inequalities Programme:
What are we doing now?
• Inequalities cuts across all LHO programmes
• London Indicators work (Geography, ethnicity, age, gender):
- Mortality
- Admissions and Access to health care
- Self assessed health
- Determinants of health
• Understanding London’s High Infant mortality rates: an analysis of
“sole-registered” births
• National Lead work:
- Local Basket of Health Inequalities Indicators (DH)
- Developing a Guide to Health Equity Audit (DH/HDA)
- Developing a Proxy for Infant Mortality at PCT level (CHI)
Uncovering Invisible Health Inequalities
Enfield
Waltham Forest
Barnet
Harrow
Redbridge
Havering
Hillingdon
Bexley
Hounslow
Richmond
Kingston
Bromley
Sutton
Croydon
The Health Equity Audit: A Definition
Source: “Health Equity Audit Made Simple.”
http://www.lho.org.uk/HIL/Inequalities_In_Health/Attachments/PDF_Files/equityauditfinal21.1.3.pdf
Supporting Health Equity Audit:
Next Steps
• Working with London’s PCTs to pilot tools for
benchmarking (equity profiling)
• Explaining the gap in Life Expectancy in London
(priorities for action)
• Modelling the effect of effective interventions across the
age spectrum (closing the audit loop)
• Analysing inequities in access to health care
- The new London HES service
Ways of Profiling Health Inequalities:
The Example of Southwark
Infant mortality rates by local authority and deprivation 1999-2001
9
8
Southwark
R2 = 0.4391
Infant mortality rate
7
A
6
B
C
5
4
3
2
1
0
0
10
20
30
40
50
60
70
Index of deprivation - index of ward scores
A: 45.3 Islington
B: 56.2 Newham
C: 61.3 Tower Hamlets
Key Messages
•
Health inequalities are everybody’s business: they exist across the whole
spectrum of health and health care
•
Health inequalities in London become painfully visible at PCT and
Neighbourhood level
•
The Geography of health inequalities is not the same across all health
issues
•
Sensible objectives for local change need to be based on an understanding
of what is comparable and what is achievable
•
LHO’s future work programme aims to:
- Increase our understanding of the dimensions of inequality
across London
- help local organisations benchmark progress compared with
others across London
- Provide a method of predicting the effect of key interventions on
the gap in Life expectancy for local interagency use
- Provide new responsive HES service to assess inequities in access
to Health care in London