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A call to action: reducing stillbirths? The public h ealth picture in the North

A call to action: reducing stillbirths? The public h ealth picture in the North. Dr Helen Duncan Programme Director, Child and Maternal Health Intelligence Network 22 nd November 2013. Mission.

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A call to action: reducing stillbirths? The public h ealth picture in the North

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  1. A call to action: reducing stillbirths?The public health picture in the North Dr Helen Duncan Programme Director, Child and Maternal Health Intelligence Network 22nd November 2013

  2. 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.” 2 The public health picture in the North

  3. Outcome-focused priorities Helping people to live longer and more healthy lives by reducing preventable deaths and the burden of ill health associated with smoking, high blood pressure, obesity, poor diet, poor mental health, insufficient exercise, and alcohol Reducing the burden of disease and disability in life by focusing on preventing and recovering from the conditions with the greatest impact, including dementia, anxiety, depression and drug dependency Protecting the country from infectious diseases and environmental hazards, including the growing problem of infections that resist treatment with antibiotics Supporting families to give children and young people the best start in life, through working with health visiting and school nursing, family nurse partnerships and the Troubled Families programme Improving health in the workplace by encouraging employers to support their staff, and those moving into and out of the workforce, to lead healthier lives 3 The public health picture in the North

  4. Intelligence Network – Strategic Context ‘The Chief Medical Officer should consider how an intelligence network for children and young people’s healthcare, which crosses all settings, can be established by 2013, to drive up standards and effective use of data, information and intelligence in decision making’ ‘This could be approached by building on the work of ChiMat, and linking it to other key registries and data collections, ensuring a strong focus on children and young people within the evidence and intelligence function of PHE and the NHS.’ Children and Young People’s Health Outcomes Forum, July 2012 ‘Improving Children and Young People’s Health Outcomes: a system wide response’, February 2013 Pledge: signed by Minister for Health Services and contributing organisations, February 2013 onwards The public health picture in the North

  5. What we want to achieve • Reduce infant and child mortality and morbidity ahead of international trends • Improve performance against the health and wellbeing outcomes detailed in the NHS and Public Health Outcomes Frameworks • Improve surveillance of the health and wellbeing outcomes recommended by the Children and Young People’s Health Outcomes Forum • Reduce variation in health and wellbeing outcomes and in the delivery standards of healthcare and public health services The public health picture in the North

  6. Annual Report of the Chief Medical Officer • The report identifies the main risk factors for stillbirths as: • Older and younger mothers • Smoking in pregnancy • Low socio-economic status of the mother • The report suggests that perinatal mortality is an indicator of maternal health and nutrition, as well as antenatal care. • Annual Report of the Chief Medical Officer 2012. Our Children Deserve Better: Prevention Pays. The public health picture in the North

  7. Stillbirths – the scale of the problem • Definition: The Office for National Statistics defines a stillbirth as ‘a child that has issued forth from its mother after the 24th week of pregnancy and that did not at any time after being completely expelled from its mother breathe or show any signs of life. • Across England there were 3,357 stillbirths in 2012, which equates to a stillbirth rate of 4.8 per 1,000 total births. In 2009 according to WHO there were estimated to be 2.6 million stillbirths worldwide, 98% of which were in low and middle income countries. The public health picture in the North

  8. Health Inequalities in the North– what the data tells us North East, North West, Yorkshire and the Humber

  9. Background demographics INDEX OF MULTIPLE DEPRIVATION, 2010 CHILDREN IN POVERTY, 2011 SCHOOL CHILDREN WHO ARE NOT WHITE BRITISH, 2013 CHILD WELLBEING INDEX 2009 The public health picture in the North

  10. Stillbirths per 1,000 total births ONS 2012; map: Child and Maternal Health Intelligence Network 3.9 5.2 5.0 England rate: 4.8 North rate: 4.9 The public health picture in the North

  11. Stillbirth rate variance across the North ONS 2012; chart: Child and Maternal Health Intelligence Network The public health picture in the North

  12. Stillbirths per 1,000 total births ONS 2012; chart: Child and Maternal Health Intelligence Network The public health picture in the North

  13. Adult obesity prevalence by ageHealth Survey for England 2009-2011 Adult (aged 16+) obesity: BMI ≥ 30kg/m2 Patterns and trends in adult obesity The public health picture in the North

  14. National Child Measurement Programme; map: Child and Maternal Health Intelligence Network % Year 6 girls who are obese: England The public health picture in the North

  15. National Child Measurement Programme, 2011/12; chart: Child and Maternal Health Intelligence Network % Year 6 girls who are obese By Strategic Health Authority The public health picture in the North

  16. Obesity prevalence by deprivation decileNational Child Measurement Programme 2011/12 Child obesity: BMI ≥ 95th centile of the UK90 growth reference The public health picture in the North

  17. Under 18 conception rate per 1,000 female population aged 15 to 17 years in England ONS 2011; map: Child and Maternal Health Intelligence Network 38.4 N. Yorkshire 19.8 35.3 Blackpool58.1 33.8 Rutland 9.4 6-fold variation across England 3-fold variation across the North The public health picture in the North

  18. % Teenage mothers (age under 18 years) Hospital Episode Statistics (HES). The NHS Information Centre for health and social care, 2011/12; map: Child and Maternal Health Intelligence Network Hartlepool2.8 2.3 1.6 1.7 Trafford 0.8 9-fold variation across England Wandsworth 0.3 3-fold variation across the North The public health picture in the North

  19. Pregnancy related hospital admissions (including delivery) by deprivation: rate per 100,000 populationHospital Episode Statistics database The public health picture in the North

  20. % Mothers aged 35 years or over Hospital Episode Statistics (HES). The NHS Information Centre for health and social care, 2011/12; map: Child and Maternal Health Intelligence Network 14.6 16.8 North East Lincolnshire 9.4 15.3 Trafford 25.2 4-fold variation across England City of London 42.6 3-fold variation across the North The public health picture in the North

  21. Public Health Outcomes Framework, 2011/12; map: Child and Maternal Health Intelligence Network % Smoking at Delivery 20.7 17.1 16.4 Blackpool, 29.7% Trafford 8.2% The public health picture in the North

  22. Variations across the North * Middlesbrough and Darlington each had fewer than five stillbirths in 2012, and therefore the actual number and rate has been suppressed. The public health picture in the North

  23. Summary Drivers - Maternal health and antenatal care The public health picture in the North

  24. To find out more • www.gov.uk/phe • www.chimat.org.uk • datagateway@phe.org.uk • Twitter@PHE_uk • Twitter@PHE_children • Helen.Duncan@phe.gov.uk The public health picture in the North

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