1. Assignment Tutorial Community Health Profile Sue Thompson

2. AIMS To enable students to develop skills in researching epidemiological data, policies and services. For students to be able to critically appraise the effectiveness of policies and services aimed at a particular health need relevant to their assigned locality.

3. Specific guidelines Identify the key health issues of the community, supported by evidence Briefly discuss the benefits of profiling the health of communities and the difficulties of accurately doing so. For ONE specific key issue, discuss its importance as a public health issue, identify services, policies and initiatives in place to address this issue – nationally, regionally and locally. Critically examine and appraise the effectiveness of these interventions, using both evidence and your own reasoned arguments.

4. Finding epidemiological data and services Where do you obtain the data? - ideastorm National Info -Dept of Health, Office of National Statistics, NICE Regional info – EMPHO, emphasis network, Local –city councils, community health profiles, PCTs Topic based websites Talk to local professionals

5. Epidemiological and Demographic information Re: Teenage Pregnancy No. of conceptions per 1,000 females aged 15-17 in 2005 per local authority area. c/w reduction in rate since 1998 England 41.1 -11.8 East Midlands 40.2 -17.5 Derby UA: 54.8 -14.1 Leicester UA :54.3 -16.0 Rutland UA :13.3 -21.1 Nottingham UA :69.3 -7.2 Derbyshire County :37.0 -11.0 Leicestershire County :30.8 -18.9 Lincolnshire :34.8 -30.5 Northamptonshire :41.9 -8.7 Nottinghamshire County :36.0 -22.5 Statistics sourced from East Midlands Public Health Observatory (2008)

6. Why is teenage pregnancy a public health issue? ‘ Teenage pregnancy is often a cause and a consequence of social exclusion. The risk of teenage parenthood is greatest for young people who have grown up in poverty and disadvantage or those with poor educational attainment. Overall, teenage parenthood is more common in areas of deprivation and poverty. Teenage parents suffer from poverty, social exclusion, lack of educational attainment and poor career prospects ( Social Exclusion Unit 1999)

7. National Strategy to tackle Teenage Pregnancy in England has four major components: a national media awareness campaign via independent radio and teenage magazines joined up action to ensure that action is co-ordinated nationally and locally across all relevant statutory and voluntary agencies better prevention through improving sex and relationships education and improving access to contraception and sexual health services support for teenage parents to reduce their long term risk of social exclusion by increasing the proportion returning to education, training or employment.

8. Common interventions aimed at reducing teenage pregnancy School-based sex education, particularly linked to contraceptive services Community based education, development and contraceptive services (e.g. youth centres) Youth development programmes: focusing on personal development (programmes that support and teach confidence, self esteem, negotiation skills), Education and vocational development may increase contraceptive use and reduce pregnancy rates Family outreach including teenagers’ parents in information and prevention programmes

9. Programme Evaluation (Nutbeam 2001) Assess Health Promotion outcomes. Intervention impact measures eg health literacy, (people more aware?) social action (people getting involved in projects and influencing them?), organisational practice and healthy public policy (organisations having interventions/policy?) Intermediate health outcomes. Modifiable determinants of health eg healthy lifestyles (evidence of behaviour change?) effective health services (are people attending? do people value the service?), healthy environments (are things changing within the locality/client group?) Long Term Health and social outcomes eg reduced morbidity/avoidable mortality and increased quality of life, functional independence ( what do the statistics say?)

10. Some examples of community health profile assignments NOT to be taken away! Read first, then discuss in pairs How do these profiles meet the assignment guidelines and how do they not? What mark would you give the assignment?