A NATIONAL PUBLIC HEALTH LANGUAGE FOR THE UK

1. A NATIONAL PUBLIC HEALTH LANGUAGE FOR THE UK Marta Calonge Contreras Information Specialist National Institute for Health and Clinical Excellence (United Kingdom)

2. The context: Public Health • Public health has been defined as “the organised process by society of mobilising local, national and international resources to protect, promote and improve the health or population and communities” (Oxford Textbook of Public Health) • Public Health is multidisciplinary: many of the factors influencing health fall within disciplines outside health itself such as housing, education, employment, etc • Information gathering is crucial for public health practice: finding out the extent of health problems, who suffers from them and what causes them in a population is the basis of public health work.

3. The context: Public Health organisations in England • Public Health Observatories (PHOs): created in 2000 to strengthen the analysis of public health information at regional level across the whole of England. • The Health Development Agency (HDA): established in 2000 with the purpose of building the evidence base in Public Health. On the 1st of April 2004 it was merged with the National Institute for Clinical Excellence and now has the remit of producing public health guidance for England

4. The need for a National Public Health Language in the UK Conversations between HDA and PHO’s started in 2003 about: • Information on the web on public health was fragmented and scattered through a huge number of resources • Public Health professionals often had to trawl through a lot of resources to find the information they needed • Need to develop a single source of readily available information that could meet all their knowledge needs. • This could be achieved through interoperability. • For interoperability to work, it was necessary that all the public health websites and resources had: • Common metadata • A common language or unified set of keywords to describe resources in a consistent way.

5. The beginnings of the language • Two significant thesauri available in the England in the field of public health: • Public Health Information Thesaurus, used by the Health Development Agency • Public Health Information Tagging System, used by the Public Health Observatories • Both vocabularies had strengths and weaknesses • They complemented each other • Work started in July 2003 to merge both vocabularies to create a single National Public Health Language (NPHL) for the UK • The NPHL was officially launched in December 2004

6. The objectives of the NPHL • Provide a common and consistent set of terms for indexing and cataloguing public health data and activities • Provide a tool for communication on how public health information can be structured and organised • Facilitate interoperability between a variety of public health websites in the UK • Allow seamless searching and structured retrieval across the internet for relevant public health data, evidence and records of practice.

7. NPHL key features • ISO 2788 compliant (International standards for thesaurus construction) • Managed in MultiTes thesaurus management software • Contains circa 3000 terms, including synonyms • Arranged in hierarchical order under 10 top level terms. • Multi-hierarchical structure (terms can appear in more than one place in the hierarchy) • 2 major releases a year • UK wide: currently adopted by several public health organisations in England, Ireland and Wales

8. NPHL Top Level Terms • Health, public health and health promotion • Determinants of health • Death, disease and disability • People and populations • Settings and places • Health services and their management • Public health methods, theory and research • Communications and knowledge • Time factors • Equipment

9. Example of an “exploded” top term Determinants of health NT1 Economics, finance and industry NT1 Education, employment and skills NT1 Environmental determinants NT2 Causes of harm NT3 Accidents NT4 Falls NT4 Traffic accidents NT4 Burns NT3 Alcohol misuse NT3 Crime NT3 Smoking Ect NT1 Food and Nutrition Etc

10. Example of NPHL term COMMUNICABLE DISEASES SN: Communicable diseases are caused by bacteria and viruses, which can be passed between people either directly, through coughs and sneezes, or indirectly through food and water or from insects’ bites. BT: DEATH, DISEASE AND DISABILITY NT: CHICKENPOX HIV INFECTION MEASLES MUMPS POLIO RUBELLA TUBERCULOSIS RT: IMMUNISATION INFECTION CONTROL SEXUALLY TRANSMITTED INFECTIONS

11. Management of the NPHL • NPHL Steering Group • To steer, manage and oversee the development of the language, and promote its implementation and use among public health organisations in the UK • Formed by representatives from NICE, the Association of Public Health Observatories, the Department of Health, the Health Protection Agency, primary care trusts, and public health organisations from Ireland, Wales and Scotland. • Meets three times a year • NPHL Editorial Board • To manage suggestions from users for changes to the thesaurus in a way that is transparent and systematic (adding new terms, deleting terms, moving terms)

12. Methods and processes for development of the NPHL • Web platform where NPHL users will be able to register • All registered users encouraged to submit changes • All validated requests will be considered by Editorial Board • Accepted changes will be included in the next release • Reason will be given for rejected changes • Transparency: process documented all along • Minor releases every 3 months (i.e. Version 1.1, 1.2 ect) • Major releases every 6 months (i.e. Version 2, 3, etc.

13. Future developments • Still in relatively early stages of development…input from users is crucial! • Integration with SNOMED CT • Translation to Welsh language • Mapping to Mesh • Development of a web portal for the NPHL • Promotion and dissemination among UK public health organisations

14. Can YOU talk Population Health? Have YOU heard of the National Public Health Language? • What is the aim of this project? • To integrate: • The PHO language for interoperable websites • The HDA/NICE language • The Department of Health Thesaurus • The Integrated Public Sector Vocabulary • The new EU Public Health Portal (Europa website) • …to ensure that a National Library for Public Health works efficiently consistently using a National, (or even International) Public Health Language Introduction: For too long, as public health professionals, we have worked with an unsystematic set of keywords to describe and frame our discipline. The explosion of opportunities in knowledge management has meant that a more systematic approach to describing our work has become necessary. Over the past few years in the UK and Australia there has emerged a developing Public Health Language. Help it develop: be part of the future! Early examples in use • Who is contributing to this work:? • Department of Health • Public Health • Observatories in Scotland, Wales, Ireland and England • - National Institute for Health and Clinical Excellence • PCTs and Public Health Networks • E-Government, • YOU? • AND there is similar work in Australia: (Public Health Classifications Project) see: http://www.nphp.gov.au/workprog/phi/index.htm What could I use a population health language for? Tagging resources in a population health knowledge management system… Labelling the filing cabinets in my department… Checking our CPD programme is comprehensive… Ensuring my personal development plan is broad as well as deep… “Consistent but flexible libraries and languages are essential to help us develop a National Knowledge Service For Public Health” Sir J A Muir Gray More details from:Peter Cornelissen (peter.cornelissen@rdd-phru.cam.ac.uk) or David Pencheon (david.pencheon@rdd-phru.cam.ac.uk).Eastern Region Public Health Observatory. www.erpho.org.uk

15. NPHL can be found athttp://www.nphl.nhs.uk/

17. Contact details Marta Calonge Contreras Information Specialist Tel: 00 44 (0) 20 7067 4797 E-mail: mcalonge-contreras@nice.org.uk