1. Public health intelligence
14 November 2012

2. Agenda Who we are and what we do The context
Public health observatories and their future
Public health intelligence
The context
Our public health intelligence tools
The big picture
Break 10 mins
Static profiles and PDFs
Interactive profiles
Some links and tips
Other useful sites
How to do screen shots, to put in your reports
Estimating
Google searches

3. Who we are Network of Public Health Observatories
Specialist health observatories
Child and Maternal (ChiMat),
national obesity (NOO),
injuries (IOBI),
learning disabilities (IHAL)
Regional health observatories
9, one of which is Eastern Region (erpho)
Public Health England (PHE)
HPA, cancer registries, PHOs, screening, NDTMS

4. What we do - health intelligence an example
Teenage pregnancy – is there a problem?
In England
In the East of England
In Suffolk
In Ipswich
In which parts of Ipswich?
What do we need to consider?
What are we comparing - teenage mothers or conceptions
What are we comparing against – Europe, England, regional av.
Small area data = small numbers
Suppression for disclosure reasons
Less reliable than big numbers
Note teenage mothers in the European atlas, not teenage conceptions

5. What data can tell us about resource allocation
Context:
What data can tell us about resource allocation
The importance of early years on outcomes
Foetal programming
Effects of deprivation – Marmot Review
Other factors

6. http://www. instituteofhealthequity

7. Foetal Programming
‘events early in life might be linked to chronic degenerative diseases such as non-insulin dependent diabetes mellitus and cardiovascular disease which do not usually appear until mid-life or later’.
Previously know as ‘the Barker Hypothesis’.
Prof David Barker
Sian Evan’s slide
Initially controversial
Relied on comparison of historical records relating to pregnancy and birth to current adult health (50-60 year time difference)
Many possible confounding factors to take into account
However, growing number of studies
Now widely accepted
Altered vulnerability to developing disease in later life
Events before birth and early life

8. Some evidence in support of foetal programming: the Dutch Hunger Winter 1944-45
German food blockade plus harsh winter led to widespread famine
Food supplies not restored until liberation 5 May 1945
Women who were pregnant during the Hunger Winter suffered under-nutrition
Sian Evan’s slide

9. The Dutch children were followed up as teenagers...
Mothers in the late stages of pregnancy during the Hunger Winter had children who were born small and had lower levels of obesity as teenagers.
Mothers in the early stages of pregnancy during the Hunger Winter had children who had higher levels of obesity as teenagers.
Sian Evan’s slide
Source: Obesity in young men after famine exposure in utero and early infancy. Ravelli et al . N Eng J Med 295;349-53,

10. Recommendations
• Increase proportion of expenditure
allocated to early years
• Support families (pre and post natal,
parenting, parental leave, transition points)
• Quality early years and outreach 10

11. Recommendations
• Increase proportion of expenditure
allocated to early years
• Support families (pre and post natal,
parenting, parental leave, transition points)
• Quality early years and outreach 11

12. Recommendations
• Increase proportion of expenditure
allocated to early years
• Support families (pre and post natal,
parenting, parental leave, transition points)
• Quality early years and outreach 12

13. http://www. instituteofhealthequity

14. Note: some maternal factors not included e. g
Note: some maternal factors not included e.g. Domestic violence and substance misuse due to small numbers self reporting.

15. Note: some maternal factors not included e. g
Note: some maternal factors not included e.g. Domestic violence and substance misuse due to small numbers self reporting.

17. http://www. instituteofhealthequity

18. Our Public Health Intelligence tools

19. The Big Picture – how is our health, all things considered?
World: Gapminder tool (not ours!)
Europe: European Health Profiles
Region / County / Local authority district:
Health Profiles
Fingertips

20. Break

21. Static profiles and specific reports
ChiMat
Child health profiles *
QIPP reports *
Needs Assessment *
Service snapshots
Other PHO
Health profiles (see Big Picture slide)
inequality indicators
Sexual health balance scorecard
Community mental health profiles
Injury profiles
Health inequality indicators,
Marmot indicators for Local Authorities
Hyperlinks to black QIPP and CH reports JULIA UPDATE

22. Interactive sites and specifics
ChiMat
Data atlas,
Profiles: child health, Breast feeding profiles, Healthy school profiles, Infant mortality profiles
PREview tools for health visitors and midwives
Outcome versus expenditure tool
Atlas of variation
Other PHOs
National Obesity Observatory – adults, children
Teenage pregnancy
GP/CCG profiles
Local JSNAs
JULIA UPDATE HYPERLINKS

23. Other useful sites not part of PHOs
ONS – populations, births, statistics on maternity, release calendar
NHS Information Centre – stats and data, portal, Infant feeding
HES online – hospital episode statistics data, freely available data
DH – breastfeeding & smoking, abortion, statistics, statistics work areas, Integrated performance measures -> maternity
DfE, DCLG, Home Office, DWP, Govt data search, etc
NOMIS - socio-economic

24. Tips and Links

25. Screenshots 1. Print screen / Prt sc Some keyboards Fn + prt sc
2. Open Word, right click to paste
4. Click on crop
Use black markers on image
to remove unwanted parts
3. Click on image, then on Picture tools tab

26. Google search tips Phrase search “”
Exact, [“child health cambridge”] but misses cambridgeshire
Search within a specific website (site:)
Searches on website, [maternity site:dh.gov.uk]
Terms you want to exclude (-)
[Ant-virus –software]
Fill in the blanks (*)
Placeholder for unknown terms, works on whole words [Marmot *involvement in * political debate]
The OR (/) operator
[teenage pregnancy statistics 2009 / 2010]

27. If data not collected, try estimating
e.g. Between 4 and 9 women in every 100 are abused during their pregnancies and/or after the birth. (Taft, 2002) from Womens Aid website
~5-10%
3857 births in Colchester Hospital, 2010/11
3857*(5/100)= 193
3857*(10/100)=386
Estimate of abuse during pregnancy of women who gave birth in Colchester hospital is between women, 2010/11
Assumptions: research sample population similar to Colchester, age, ethnicity etc., one woman one baby…
69,950 births in East of England 2010/11

28. James.harrison@erpho.org.uk Julia.yelloly@chimat.org.uk
Thanks!