1. Factors influencing take-up of immunisation in children Meic Goodyear Marion Gibbon Lewisham PCT

2. Characteristics of Lewisham Inner city borough High levels of deprivation Ethnic diversity Young age profile High mobility

3. Lewisham IMD by SOA

4. Take-up of MMR & D3

5. MMR take-up at SOA level Each coloured area is an SOA with at least one 2yo patients registered with a Lewisham GP

6. D3 take-up at SOA level

7. Data available PIMS child health: complete cohort population data, with immunisation record Exeter: residence and GP registration Ordnance survey Codepoint & boundaries ONS 2001 Census

8. What might affect take-up? Deprivation? Affects most aspects of health Regress take-up rates at SOA level against IMD overall score

9. Correlation, take-up and IMD Parents who have children immunised with D3 are more likely to accept MMR At the margin, there is a small but significant positive correlation between deprivation and MMR take-up – the more deprived the more likely to be immunised

10. What else to look at? Ethnicity? Data only available from 2001 census, so ecological Given wide range of ethnic groups in Lewisham, first just investigate white British vs all others Regress immunisation take-up rates against fraction of SOA population describing themselves as White British

11. Correlation, take-up fraction and % white British There is a significant negative correlation between take-up rates and the proportion of people who regard themselves as White British, suggesting that the White British are the group to whom message need to be targetted

12. What next? Market research data? Mosaic? Investigate social marketing approaches.