The role of the Public Health Observatories (PHOs)

1. The Work of the Public Health ObservatoriesDr Bobbie JacobsonDirector, London Health Observatorywww.lho.org.uk

2. The role of the Public Health Observatories (PHOs) To work in partnership with researchers, regional and local health policymakers and practitioners to: • Monitor trends in health and its determinants; • Highlight future health problems; • Assess the health impact of potential and past policies • Draw together information from different sources and to identify groups in formation Adapted from “Saving Lives-Our Healthier Nation”

3. The Association of Public Health Observatories (APHO) - At A Glancewww.pho.org.uk

4. The Public Health Observatories: Spectrum of Activity

5. The Public Health Observatories: Pivotal Role In Public Health Intelligence?

6. Association of Public Health Observatories: Examples Of Current Joint Work • Primary Care: Developing a common dataset of PCT health indicators (ERPHO) • Health inequalities: Developing a basket of local indicators and a tool kit on health equity audit, review of ethnicity & vital statistics (LHO) • CHD: Equity profiling (SEPHO) • Access to datasets: eg. Hospital, HES, ONS mortality dat from DoH, ONS and CDSC (Communicable Disease Surveillance Centre) (N&Y PHO) • National Website: Developing a central point of access for all PHO users (NWPHO) • Common Electronic Search Language: Devising a common thesaurus of search items across all PHOs and HAD (ERPHO)

7. 1. Network Development and Communications 2. Website Development 3. Widening Data/Information Access 4. Health Impact Assessment 5. Tackling Health Inequalities 6. “Diversity Counts” - Ethnic Health Intelligence Programme 7. PCT information programme 8.National/International work 9. Mental Health LHO Current Work Programme 2002/3

8. One Stop Access to Data / Information - some examples • London data on illicit drugs • EU Alcohol policy / harm in young people • London Injury and Accidents Local Datasets • Census: specially commissioned data (GLA/PCTs) • HES data • Crime and A&E data

9. National targets for tackling Health Inequalities • Infant Mortality (Deaths in the first year of life) “Starting with children under one year, by 2010 to reduce by at least 10% the gap in mortality between routine and manual groups and the population as a whole” • Expectation of Life“Starting with local authorities, by 2010 reduce by at least 10% the gap between the fifth of areas with the lowest life expectancy at birth and the population as a whole.”

10. Additional Targets with an Inequalities Dimension • To reduce smoking rates among manual groups from 32% in 1998 to 26% by 2010. • To reduce conception rates in under 18s by 15% by 2004 and 50% by 2010, while reducing the gap between the worst fifth of wards and the average by at least a quarter. • To reduce child poverty by half in ten years and eradicating it in a generation.

11. Life Expectancy at Birth in London 2001 Male Female

12. Life Expectancy in London by Deprivation Quintile (1997-9)Source: “Mapping Inequalities in Health Across London”, LHO

13. Geographic Inequalities in Infant Mortality in London by Borough 1999-2001Source: “Health In London Report”, forthcoming

14. Infant Mortality by Index of DeprivationSource: “Health In London report”, forthcoming

15. Infant mortality rates by social class and registration type 1993-99 Target groups

16. Specific infant mortality rates by registration type, London 1993-99

17. Infant mortality rates by mothers birthweight and registration type, London 1993-99

18. Next Steps • Detailed analysis of risk factors from North West Thames Maternity Dataset (SMMIS) • Development of statistically valid proxy indicator (set) at PCT / local authority level