GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Day 2: Datasets Jennie Mussard, Croydon PCT James Hebblethwaite, Kensington & Chelsea PCT

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Discussion What demographic or health data has been collected about you or your family in the last few months?

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Populations and geography James Hebblethwaite Based upon a presentation produced by the South West Public Health Observatory

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Data through our lives Environment and lifestyle Death Birth Healthcare Childhood

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Learning outcomes  Why do we want to know about populations?  Present and future patterns of demographic change  Sources of population data and their strengths and weaknesses  The impact of migration  Ethnic groups and ethnicity data  Geographical hierarchy and classification

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Why do we want to know about populations and geography?

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Why are we interested?  Anticipating future needs  Denominator  Population at risk  Cash

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory What sort of things do we want to know about a population?  Size  Age structure  Fertility  Ethnic mix  Projected changes – fertility, mortality, mobility You will notice that this is the first stage of a needs assessment

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory The next few slides are population pyramids for different areas They are all to the same scale What could you guess about the health needs of these populations? Population pyramids (or trees)

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Africa 2000 Size? Age structure? Fertility?

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Asia 2000 Size? Age structure? Fertility?

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory China 2000 Size? Age structure? Fertility?

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Europe 2000 Size? Age structure? Fertility?

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Present and future patterns of population change

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory The rectangularisation of the life curve England and Wales

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Births and deaths England and Wales Source: ONS

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory National Projections UK population to rise to 65m by 2016

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory London projections suggest a much more modest growth in number of older people

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Change in fertility patterns (Age-groups at which fertility is highest) 1986 & Source: Population trends Autumn 2008

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Longer term projections depend partly on fertility

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Population change England and Wales Source: Population Trends Autumn 2008

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory The same principles apply at local planning level what sort of services might we need to provide for these wards?

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Exercise: population pyramids Aim: to demonstrate the differences between population projections and learn how to create population pyramids

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Sources of population data

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Sources of population data General Practice - Registered population - Exeter registered resident - Strategic Tracing Service Counts, estimates, projections GLA Low projections High projections Office for National Statistics Census - Mid year estimates - Subnational population projections Local Authority -Electoral Roll - School Roll - Local Planning data

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory National Statistics – Census and Mid Year Estimates Subsequent estimates Mid Year Estimates 2001 Add births Subtract deaths Adjust for migration 2001 Census Adjust for under- enumeration Adjust April to June Migration: 1. Internal (GP registrations) 2. International (long term – 12+ months; short term 6-12 months)

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GLA projections  Constructed using births, deaths, migration assumptions etc but CONSTRAINED by available housing stock, as detailed in the London Housing Capacity Study  Generally considered to be more accurate than ONS for planning purposes Low is entirely driven by the increase in homes as seen annually since mid-2001 from data collected at borough level by the LDD up to 2007 and the LHCS/boroughs from 2007 to High was prepared to establish the impact on London of the ONS 2006-based population projection for England. The PLP High assumes that each London borough’s proportion of England’s net international migration for the years mid-2001 to mid-2006 will continue based on the ONS assumption for international migration.

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Resident versus registered populations

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GP registration (“Exeter system”)  Used to provide internal migration estimates  Useful for producing patient distribution maps, working out distance between patient and health centre etc  Problems with:  Delay in re-registering on re-location (particularly a problem in university towns)  Failure to de-register on leaving the country - still called “embarkation” (particularly a problem where many foreign students or migrant workers)  Results in ‘list inflation’

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Local authority data  Local authority planners able to provide detail on proposed developments not included in GLA projections  Electoral roll can be useful for picking up possible population growth not identified by other sources

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Population data: strengths and weaknesses CensusONS Mid year estimate ONS Projecti ons GLA Projecti ons ExeterLocal Authority Resident pop Registered pop Includes ethnicity National comparisons Available at small areas Regularly updated Accounts for housing stock Yes Partly Yes Partly No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Who’s missing?  Homeless  Less than 6 months?  Travellers  Illegal immigrants  Unregistered migrant workers  “Special populations”  Armed forces and dependents  Prisoners

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory The impact of migration

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Population mobility Population mobility may mean that the numbers are the same, but their needs are different (may be 30% in some areas and age groups) Kensington & Chelsea You can work this out using Exeter data

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Ethnic groups and ethnicity data

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Ethnicity and its relevance to health needs assessment  Healthy migrants? – how does this change over time?  Different patterns of mortality and morbidity  Immigrant groups may have a different age distribution according to migration patterns and ageing

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Ethnic breakdown – 2001 Census LondonEngland White British59.8%87.0% White Irish3.1%1.3% Other White8.3%2.7% Mixed White and Black Caribbean1.0%0.5% Mixed White and Black African0.5%0.2% Mixed White and Asian0.8%0.4% Other Mixed0.9%0.3% Indian6.1%2.1% Pakistani2.0%1.4% Bangladeshi2.2%0.6% Other Asian1.9%0.5% Black Caribbean4.8%1.1% Black African5.3%1.0% Other Black0.8%0.2% Chinese1.1%0.5% Other ethnic group1.6%0.4%

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Standardised mortality ratios by country of birth, aged 20-29, circulatory diseases, England and Wales Source: London Health Observatory

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Self-reported bad or very bad general health by minority ethnic group HSE 2004

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Ethnicity data  Sources of data:  2001 Census  GLA ethnic projections  ONS experimental statistics  Exeter for place of birth  GP and special surveys (quality varies)  Hospital and other service data (quality varies)

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Geographical hierarchy and classification

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Geographic boundaries

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Borough

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Ward

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory LL SOA

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Output area

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory NS 2001 Area Classification for Health Areas

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Population segmentation tools  Commercial organisations also supply population segmentation tools  Common examples:  Mosaic  Acorn

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory

GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Learning outcomes  Why do we want to know about populations?  Present and future patterns of demographic change  Sources of population data and their strengths and weaknesses  The impact of migration  Ethnic groups and ethnicity data  Geographical hierarchy and classification