1. Health Impact Assessment & Mental Wellbeing Local Health and Wellbeing Indicators Lorraine Fahy Research Analyst Ireland and Northern Ireland’s Population Health Observatory (INIsPHO)

2. Health Impact Assessment & Mental Wellbeing  Introduction to INIsPHO  Local health and wellbeing indicators o Use o Development o Examples

3. INIsPHO Established in 2005 Housed in the Institute of Public Health (IPH) An all-Ireland observatory Supports each jurisdiction while maximising benefits of North/South working Source of health intelligence/health information

4. INIsPHO Better intelligence… Better decisions… Better health…

5. Some current work Irish Health Poverty Index (iHPI) All Ireland Health and Social Care Indicator Set (AIHSC) Injury Observatory for Britain and Ireland (IOBI) Health Analysts’ Special Interest Group eTools o INIsPHO eData system o All-Ireland electronic Health Library (AIeHL) Event Series

11. Local health and wellbeing indicators

12. Factors affecting health & wellbeing Complex array of political, social, economic and environmental factors - and health and social services issues - that affect the health of a population Current health status as well as the future health status of an area

13. 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

14. Uses of local health indicators Guiding local and national action: Putting the local situation into a broader context Providing a national view of what’s going on at the local level Awareness raising – keeping health inequalities, their determinants and the needs of vulnerable populations on the agenda Specific applications facilitated by regional comparisons: Local needs assessment & health impact assessment Planning and delivery of health and social services National co-ordination of local efforts Monitoring broad progress on tackling health inequalities

15. INIsPHO development of local health indicators No system for monitoring local health across the whole island Adapted two existing datasets to the whole island English Health Poverty Index (eHPI) www.hpi.org Irish Health Poverty Index (iHPI) Northern Ireland Health Inequalities Monitoring System www.dhsspsni.gov.uk/index/stats_research/stats-equality.htm All-Ireland Health and Social Care Indicator Set (AIHSC)

16. 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 –North and South –North only –South only

17. iHPI conceptual framework

18. A flavour of the information collected Health data: –Mortality and morbidity data –Life expectancy –Hospital admissions –Physical morbidity: benefits received for different types of physical conditions –Health and social services resourcing –Utilisation and access to health services

19. Mental health data: –Living alone –Psychological morbidity –Suicide –Psychiatric admissions –Prescribing for anxiety and depression –Social support scale –Can people be trusted? A flavour of the information collected

20. 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

21. Web-based visualisation tool Tables, maps, spider plots and other charts An exploratory tool to look at: –Relationship between measures (at an area level) –Geographical variation in a single measure across the island –Profiles of a single area based on multiple-measures –Geographical comparisons based on multiple measures –Changes over time (when updated)

22. www.inispho.org/ihpi www.inispho.org/aihsc Accessing the datasets

23. Data briefings

24. A selection of Local Health and Wellbeing Indicators

25. Life expectancy – Northern Ireland vs Republic of Ireland Northern Ireland Republic of Ireland Highest male life expectancy 78.1 years (Ballymoney) 76.9 years (Roscommon) Lowest male life expectancy 73.5 years (Belfast) 72.8 years (Leitrim) Highest female life expectancy 82.4 years (Ballymoney) 82.2 years (Roscommon) Lowest female life expectancy 79.3 years (Derry) 79.3 years (Limerick)

26. Male life expectancy by LGD and county, 2002-2004

27. Female life expectancy by LGD and county, 2002-2004

28. Northern Ireland: Comparison of LGD with highest male life expectancy (Ballymoney) with LGD with lowest male life expectancy (Belfast)

29. Northern Ireland: Comparison of LGD with highest female life expectancy (Ballymoney) with LGD with lowest female life expectancy (Derry)

30. Comparing the most deprived LGD (Strabane) with the least deprived LGD (North Down)

31. Future 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

32. Discussion