Health and our surroundings Integrating regional environmental data with regional health data Invisible Assets, 24 October 2008 Steve Barron

Institute of Public Health in Ireland (IPH) All-Ireland body North-South cooperation on public health Focus on reducing inequalities in health Three main strands to our work: o Capacity building o Policy support o Information and intelligence (INIsPHO)

Health and our surroundings Why we need a broad range of information to measure local health IPH work on the development of local health data –Irish Health Poverty Index (iHPI) –All-Ireland Health and Social Care Indicators (AIHSC) Potential for incorporating local environmental data Moving forward

Why we need a broad range of information to measure local health

The determinants of health and wellbeing

National data and local data Wide range of data available at national level on the broad determinants of health National figures can mask important differences at regional and local level Comprehensive data at local level on the broad determinants of health is needed to identify and address inequalities

IPH work on the development of local health data

IPH development of local health data No system for monitoring local health across the whole island Longer term interest in: –An all-Ireland suite of local health and wellbeing indicators –A basis of local health and wellbeing profiles –Links to comparative European data

IPH development of local health data Adapted two existing datasets to the whole island at a local level English Health Poverty Index (eHPI) Irish Health Poverty Index (iHPI) Northern Ireland Health Inequalities Monitoring System All-Ireland Health and Social Care Indicators (AIHSC)

Conceptual framework

Collation of data Collated data on 82 indicators for 52 local regions across the island Local level: –26 Local Government Districts in the North –26 (traditional) counties in the South How comparable are measures from two different jurisdictions? Four categories of measures: –All-Ireland –Separate North and South –North only –South only

A flavour of the information collected Health data: –Mortality data and life expectancy –Hospital admissions –Obesity –Psychological morbidity: suicide, psychiatric admissions –Physical morbidity: benefits received for different types of physical conditions –Low birth weight –Health and social services resourcing Economic data: –GDP per capita –House prices –Change in job supply

Lifestyle data: –Physical activity –Smoking –Fruit and vegetable consumption –Alcohol abuse –Drug misuse Educational data: –Educational resourcing –Pupil to teacher ratio –Educational attainment A flavour of the information collected

Environmental data (social and physical): –Community stability –Perceptions of neighbours’ trustworthiness –Social networks –Housing quality –Crime rates –Living alone A flavour of the information collected

The web-based visualisation tool Incorporated into the more flexible INIsPHO eData website ( or Tables, maps, spider plots and other charts An exploratory tool to look at: –Geographical variation in a single measure across the island –Relationship between measures (at an area level) –Profiles of a single area based on multiple-measures –Geographical comparisons based on multiple measures –Changes over time (when updated)

Potential for incorporating local environmental data

The common geographical unit in Republic of Ireland across many sectors is county Much environmental data would not make sense at county level – environmental factors do not heed county boundaries! Air quality measured in by 26 stations over four zones: Dublin city, Cork city, 15 urban areas, rest of the country Rivers flow through a number of counties Bathing water only exists in some counties What environmental data do we have available to match our health data?

It is more feasible to assign environmental data to counties where environmental systems are organised by people: –Household waste (EPA National Waste Report) –Water supplies (EPA Provision and Quality of Drinking Water)

Household waste per person 2006 Ireland: 394kg Sligo: 276kg Louth: 581kg

Quality of drinking water Ireland: 97.3% Kildare, Offaly, Westmeath: 99%+ Mayo: 91.7% Overall compliance with microbiological, chemical, and indicator values

Moving forward

We are currently combining the two datasets (iHPI and AIHSC) and expanding with census information But we don’t want to continue past this unless we –Can support key functions –Link to other data sources –Can work with other key stakeholders Useful but a good start at best !

An aspiration Core set of agreed local health and wellbeing indicators across a broad range of factors Collated and regularly updated across the island Support a range of planning, delivery and monitoring functions A basis of local health and well-being profiles Help support learning and sharing of best practice from one area to another Ultimately deliver support for better health – not just information!

Health and our surroundings Integrating regional environmental data with regional health data Questions