Lifestyle Data

Agenda The need for lifestyle data/current drivers –LDPs –LPSAs/LAAs Potential sources of lifestyle data Relevant current APHO projects –Review of sources –Child Obesity measurement –Community Profiles –Lifestyle Survey Toolkit

Lifestyle risk factors Smoking Lack of physical activity Unhealthy diet Obesity Excessive alcohol consumption/binge drinking Drugs Risky sexual behaviour Not breastfeeding

Why do we need lifestyle data? Needs Assessment To identify adverse trends/future problems and/or... Compare local areas/pop. sub-groups in order to... Help PCTs/partners establish priorities and plan action Awareness raising/campaigning To generate a local profile in order to... Lobby for resources Help to communicate important public health messages and empower local people to take informed choices/action Measuring progress/performance Outcome measures for services Progress re LPSA/LAA targets and LDPs

PCTs’ LDP reporting requirements current: –Smoking status amongst the population aged 15 to 75 years Number of people aged 15 to 75 years on a GP register, recorded as being a smoker in the last 15 months. Number of people aged 15 to 75 years on a GP register, with a smoking status recorded in the last 15 months. –Obesity Status amongst the GP registered population aged 15 to 75 years Number of people aged 15 to 75 years on GP register, recorded as having a BMI of 30 or greater in the last 15 months Number of people aged 15 to 75 years on GP register, with a BMI recorded in the last 15 months. future: –child obesity prevalence –?further alignment with Choosing Health

LPSA/LAA reporting requirements LAA roll out new LAA guidance current examples –Nottingham –Derby outcomes framework reward element the role of GOEM and EMPHO

Sources of Lifestyle Data

What’s the best source of local information on.... Possible source National Surveys (local boosts of) National Surveys (estimates based on) Regional or local surveys Primary Care/ other NHS Data Commercial datasets smoking physical activity diet obesity alcohol

Main National Surveys National surveys with health-related lifestyle content include: –Health Survey for England –General Household Survey –Psychiatric Morbidity Survey (drugs, alcohol) –ONS Omnibus Survey

Main National Surveys (cont.) Infant feeding survey Food & expenditure survey National diet & nutrition survey National survey of sexual attitudes & lifestyles (NATSAL) Drug use, smoking and drinking among young people in England in 2001

Where to find national surveys ONS Department of Health y/fs/en y/HealthSurveyForEngland/fs/en UK Data Archive

What’s the best source of local information on.... Possible source National Surveys (local boosts of) National Surveys (estimates based on) Regional or local surveys Primary Care/ other NHS Data Commercial datasets smoking physical activity diet obesity alcohol

Buying local “boosts” of national surveys Some PCTs (Merseyside, Camden, Islington) have bought local boosts of the HSfE At around £100 per person this can be very expensive to get a useful level of precision in prevalence estimates Cost savings possible with cut-down interview and measurement schedules

Generating local estimates based on national surveys A quick way of providing a profile of the population when there is no “real” local data Appropriate when local demography is similar to national demography

Erewash PCT: Estimated smoking prevalence by age (Men) Age group Male Est.Smoking Prevalence % Estimated No. Adults 16+Smokers % % % % % % %305 Erewash PCT: Estimated smoking prevalence by age (Women) Age group Female Est.Smoking Prevalence % Estimated No. Adults 16+Smokers % % % % % % %532

Erewash PCT: Estimated smoking prevalence by in Electoral Wards CAS Ward NamePopulationEstimated SmokingEstimated Prevalence %No. Smokers Little Eaton and Breadsall Sandiacre North Ockbrook And Borrowash Old Park Draycott Ilkeston Central Sandiacre South Sawley Nottingham Road Derby Road East Long Eaton Central Kirk Hallam West Hallam and Dale Abbey Cotmanhay Stanley Breaston Ilkeston North Little Hallam

DH/NatCen ward-level “synthetic estimates” Dept of Health project Using data from the Health Survey for England Multivariate modelling to identify social and demographic predictors of smoking Ward-level estimates based on known social and demographic characteristics of ward populations Validated against local surveys in London and N.W. England Publication date – July 29 th 2005 –adult smoking –adult binge drinking –adult obesity –adult fruit and veg consumption –child fruit and veg consumption

West Midlands Regional Lifestyle Survey 2005 West Midlands Public Health Observatory

West Midlands Regional Survey 2005 Coordinated by WMPHO. Delivered by BMG. 56 funding partners including PCTs, LAs, GO, LSCs, Police Sampling frame = Public Access Electoral Register Self-completion questionnaire sent to 174,000 adults aged 18 and over Overall response rate = 33.1% The survey “ has fostered partnership working”

A local health survey: 1999 and 2002 Erewash Health Surveys

Erewash Health Survey: Design two age groups (25-34 & 65-74) two samples compared: –a random sample of all residents –a random sample of residents of the most deprived areas (Sawley, Cotmanhay and Kirk Hallam ) postal questionnaire

Erewash Health Survey 1999: Response People aged –menrepresentative38% –womenrepresentative59% –mendeprived areas33% –womendeprived areas50% People aged –menrepresentative82% –womenrepresentative81% –mendeprived areas83% –womendeprived areas76%

Lifestyle data from general practice potential source for data on smoking and obesity... but not (yet) other aspects of lifestyle LDP reporting obligations - current focus is still data quality QOF provides some financial incentives for improved data collection but scheme is essentially voluntary unregistered and non-attenders (incl some vulnerable groups) not represented QPID will provide summaries of prevalence at practice level but not (yet) for geographically defined populations the source of the future??

Lifestyle data from commercial market research organisations e.g. CACI, Claritas, Experian, Acxiom incl. smoking, expenditure on food and drink, obesity large volumes of household survey and consumer data modelled to provide estimates for all areas of the country methodologies obscure expensive

General Issues for Data Collection Systems Validity: does the system measure what it aims to measure? Reliability: –do questions produce reproducible answers? –inter-observer differences –recall of past events Comparability... e.g. vs neighbouring areas Timeliness Accuracy of data capture/data entry Cost Particular Issues for “Censuses” Completeness Particular Issues for Sample Surveys Bias – is the sample representative of the target population? Precision - is the sample size adequate?

Horses for courses: different systems suit different purposes Compare between localities Track progress on LPSA/LAA targets and Local Delivery Plans (LDPs). Outcome measures for services

Relevant current APHO projects 1.Review of sources of lifestyle data 2.Child Obesity measurement (Task Force project) 3.Community Profiles (Task Force project) 4.Lifestyle Survey Toolkit