Trend in the Infant Mortality Rate % relative gap between the most deprived quintile and England by region, compared to the national health inequalities target of a 10% reduction between baseline and target, progress at David Merrick Public Health Information Specialist Yorkshire & Humber PHO

“Promoting and delivering public health intelligence” Summary The national health inequalities infant mortality target is for a 10% narrowing in the % relative gap between the Routine and Manual Socio- economic group and England as a whole A regional version of this target would be difficult to measure because of problems with linking the birth and death files in order to allocate SEG to each birth, and also because the number of births in this group is quite small at a regional level YHPHO have developed a proxy measure which is likely to reflect the each region’s contribution to the achievement of the national target. The Review of the Health Inequalities Infant Mortality PSA (DH February 2007) recommends this approach. The following slides show the progress that has been made towards narrowing the infant mortality rate % relative gap between each region’s lower super output areas that among the 20% most deprived in England and England as a whole. For each region charts show –Trends of the infant mortality rates with 95% confidence intervals –The % relative gap which is the regions most deprived quintile rate expressed as a percentage of the England rate –The excess number of infant deaths occurring in the regions LSOAs that are in England’s MDQ compared to England as a whole Infant mortality % relative gap forecasts (with 95% confidence interval) were made using Holt’s Exponential Smoothing on data from up to This technique gives more weight to more recent values in the time series. Comparing the forecast with the red target line is a method of assessing the likelihood that the actual relative gap will be 10% narrower in than it was in , i.e. will the ‘target’ be achieved? The PHO have given each PCT a ‘traffic-light’ that summarises whether the trajectory of observed values is consistent with a 10% narrowing by This assessment is based on a comparison of the target line with the forecast and its confidence interval. –ON-TRACK ~ Forecast below target –NEAR-TRACK ~ Forecast above target but confidence interval includes target –OFF-TRACK ~ Forecast and it’s confidence interval above target This PHO assessment is independent of any assessment made by the Department of Health, that may use different criteria for determining the ON/OFF TRACK status in this respect. An alternative criteria for assigning ON/OFF TRACK status would be a simple comparison of the most recent relative gap with the target line. While this approach is entirely objective, it ignores trajectory which is likely to reduce predictive performance given the volatility of the relative gap statistic.

“Promoting and delivering public health intelligence” National health inequalities 2010 PSA infant mortality target proxy*: progress at RegionRelative gap North EastOff-Track North WestOff-Track Yorkshire and HumberNear-Track East MidlandsNear-Track West MidlandsOff-Track East of EnglandOn-Track LondonNear-Track South EastNear-Track South WestOn-Track *10% narrowing of infant mortality relative gap between regions LSOAs in England’s most deprived quintile and England from baseline and target. Relative gap is rate in deprived quintile expressed as a percentage of England rate.

“Promoting and delivering public health intelligence” Most deprived quintile vs England North East Region

“Promoting and delivering public health intelligence” Most deprived quintile vs England North West Region

“Promoting and delivering public health intelligence” Most deprived quintile vs England Yorkshire & Humber Region

“Promoting and delivering public health intelligence” Most deprived quintile vs England East Midlands Region

“Promoting and delivering public health intelligence” Most deprived quintile vs England West Midlands Region

“Promoting and delivering public health intelligence” Most deprived quintile vs England East of England Region

“Promoting and delivering public health intelligence” Most deprived quintile vs England London Region

“Promoting and delivering public health intelligence” Most deprived quintile vs England South East Region

“Promoting and delivering public health intelligence” Most deprived quintile vs England South West Region