1. Introduction to Lifestyle Data Peter Cornish South East Public Health Intelligence Analyst Training Day 2, Session 4 11 th February 2016

2. Session 1 – Data access and information governance Lifestyle is one of the wider determinants of health Factors include physical activity, smoking, alcohol and drug use, as well as attitudes towards behaviour 2 Session 4 – Lifestlyle Data Session 4 – Lifestyle Data South East Public Health Intelligence Analyst Training, Day 2, 11th February 2016

3. Session 1 – Data access and information governance Potential data sources National surveys e.g. Health Survey for England Synthetic estimates based on national surveys Local surveys Data from primary care Data from commercial/market research organisations 3 Session 4 – Primary data sources Session 4 – Lifestyle Data South East Public Health Intelligence Analyst Training, Day 2, 11th February 2016

4. Session 1 – Data access and information governance Health Survey for England 4 Annual Core Questions, Trend Monitoring: e.g. BMI, Waist Circumference, Smoking, Alcohol, Fruit & Veg Intake Annual Core Questions, Trend Monitoring: e.g. BMI, Waist Circumference, Smoking, Alcohol, Fruit & Veg Intake Focus Topics e.g. Physical Activity, Sexual Health, Wellbeing Session 4 – Lifestyle Data South East Public Health Intelligence Analyst Training, Day 2, 11th February 2016

5. Session 1 – Data access and information governance Surveys with Lifestyle Sections Integrated Household Survey - Smoking prevalence (PHOF) Opinions and lifestyle survey – Smoking, Drinking Active People Survey – Physical activity, Excess Weight (PHOF) Smoking, drinking and drug use among young people What about YOUth? – New survey, smoking in 15 year olds 5 Session 4 – Lifestyle Data South East Public Health Intelligence Analyst Training, Day 2, 11th February 2016

6. Session 1 – Data access and information governance Why are surveys useful? Can measure populations that don’t come into contact with services Can measure issues that are not routinely recorded, e.g. healthy eating, physical activity levels Can help us to understand the link between disease and determinant, e.g. income and mental health National surveys are often not large enough to provide data below regional level – data aggregation / local boost samples may be options… 6 Session 4 – Lifestyle Data South East Public Health Intelligence Analyst Training, Day 2, 11th February 2016

7. Session 1 – Data access and information governance Surveys 7 Advantages Flexibility Robust methodology Comparability with national, regional and other benchmarks Disadvantages Lack of local historical trend data Costs Session 4 – Lifestyle Data South East Public Health Intelligence Analyst Training, Day 2, 11th February 2016

8. Session 1 – Data access and information governance Validity Reliability Accuracy Bias Precision Timeliness Cost 8 Some criteria for assessing and comparing different sources -Does it measure what it aims to measure? -Do questions produce reproducible answers? -Measurement or data entry? -Is the sample representative? -Adequate sample size? Session 4 – Lifestyle Data South East Public Health Intelligence Analyst Training, Day 2, 11th February 2016

9. Session 1 – Data access and information governance Synthetic estimates 9 Advantages Comprehensive geographical coverage - allows comparative analysis between areas. Ease of access/cost. The estimates are in the public domain, are immediately accessible to users and are free of charge. Disadvantages Lack of flexibility – particular local requirements cannot be specified. Lack of sensitivity to local lifestyle interventions. They represent expected prevalence so additional local factors that may impact true prevalence are not taken into account, so should not be used to measure change over time. Session 4 – Lifestyle Data South East Public Health Intelligence Analyst Training, Day 2, 11th February 2016

10. Session 1 – Data access and information governance Data from primary care QOF – Smoking, Obesity, Lifestyle Advice, Local data extraction (if facility available) Health check data (if facility available) Selective focus on particular patient groups e.g. Health checks 40-74 no CVD, Inactivity in Hypertension QOF – ‘Record of’ e.g. alcohol consumption Variability between practices in the completeness and quality of data recording, under estimation (Obesity 9%) Geographical focus 10 Session 4 – Lifestyle Data South East Public Health Intelligence Analyst Training, Day 2, 11th February 2016

11. Session 1 – Data access and information governance Data from commercial organisations e.g. CACI, Claritas, Experian, Acxiom, Dr Foster large volumes of household survey and consumer data modelled to provide estimates for all areas of the country of: - expenditure on tobacco, food and drink - prevalence of smoking and obesity 11 Session 4 – Lifestyle Data South East Public Health Intelligence Analyst Training, Day 2, 11th February 2016

12. Session 1 – Data access and information governance Data from commercial organisations Advantages Extensive geographical coverage Estimates often available at Output Area or Super Output Area level. Disadvantages Detailed methodologies are often not available Potential for bias (lack of random sampling / poor response rates) Cost – expensive? 12 Session 4 – Lifestyle Data South East Public Health Intelligence Analyst Training, Day 2, 11th February 2016

13. Session 1 – Data access and information governance Survey Links HSE - http://www.hscic.gov.uk/healthsurveyenglandhttp://www.hscic.gov.uk/healthsurveyengland Integrated Household Survey – http://www.ons.gov.uk/ons/guide-method/method-quality/specific/social-and- welfare-methodology/integrated-household-survey/index.html Active People – http://www.sportengland.org/research/who-plays-sport/active-people- interactive/ NatCen Social Research – www.natcen.ac.ukwww.natcen.ac.uk UK Data Service - https://www.ukdataservice.ac.ukhttps://www.ukdataservice.ac.uk 13 Session 4 – Lifestyle Data South East Public Health Intelligence Analyst Training, Day 2, 11th February 2016