1. Lifestyle Data

2. Agenda The need for lifestyle data/current drivers –LDPs –LPSAs/LAAs Potential sources of lifestyle data Relevant current APHO projects –Review of sources –Child Obesity measurement –Community Profiles –Lifestyle Survey Toolkit

3. Lifestyle risk factors Smoking Lack of physical activity Unhealthy diet Obesity Excessive alcohol consumption/binge drinking Drugs Risky sexual behaviour Not breastfeeding

4. Why do we need lifestyle data? Needs Assessment To identify adverse trends/future problems and/or... Compare local areas/pop. sub-groups in order to... Help PCTs/partners establish priorities and plan action Awareness raising/campaigning To generate a local profile in order to... Lobby for resources Help to communicate important public health messages and empower local people to take informed choices/action Measuring progress/performance Outcome measures for services Progress re LPSA/LAA targets and LDPs

5. PCTs’ LDP reporting requirements current: –Smoking status amongst the population aged 15 to 75 years Number of people aged 15 to 75 years on a GP register, recorded as being a smoker in the last 15 months. Number of people aged 15 to 75 years on a GP register, with a smoking status recorded in the last 15 months. –Obesity Status amongst the GP registered population aged 15 to 75 years Number of people aged 15 to 75 years on GP register, recorded as having a BMI of 30 or greater in the last 15 months Number of people aged 15 to 75 years on GP register, with a BMI recorded in the last 15 months. future: –child obesity prevalence –?further alignment with Choosing Health

6. LPSA/LAA reporting requirements LAA roll out new LAA guidance current examples –Nottingham –Derby outcomes framework reward element the role of GOEM and EMPHO

7. Sources of Lifestyle Data

8. What’s the best source of local information on.... Possible source National Surveys (local boosts of) National Surveys (estimates based on) Regional or local surveys Primary Care/ other NHS Data Commercial datasets smoking physical activity diet obesity alcohol

9. Main National Surveys National surveys with health-related lifestyle content include: –Health Survey for England –General Household Survey –Psychiatric Morbidity Survey (drugs, alcohol) –ONS Omnibus Survey

10. Main National Surveys (cont.) Infant feeding survey Food & expenditure survey National diet & nutrition survey National survey of sexual attitudes & lifestyles (NATSAL) Drug use, smoking and drinking among young people in England in 2001

11. Where to find national surveys ONS http://www.statistics.gov.uk/ http://www.statistics.gov.uk/lib2001/index.html Department of Health http://www.dh.gov.uk/PublicationsAndStatistics/PublishedSurve y/fs/en http://www.dh.gov.uk/PublicationsAndStatistics/PublishedSurve y/HealthSurveyForEngland/fs/en UK Data Archive http://www.data-archive.ac.uk/

12. What’s the best source of local information on.... Possible source National Surveys (local boosts of) National Surveys (estimates based on) Regional or local surveys Primary Care/ other NHS Data Commercial datasets smoking physical activity diet obesity alcohol

13. Buying local “boosts” of national surveys Some PCTs (Merseyside, Camden, Islington) have bought local boosts of the HSfE At around £100 per person this can be very expensive to get a useful level of precision in prevalence estimates Cost savings possible with cut-down interview and measurement schedules

14. Generating local estimates based on national surveys A quick way of providing a profile of the population when there is no “real” local data Appropriate when local demography is similar to national demography

15. Erewash PCT: Estimated smoking prevalence by age (Men) Age group Male Est.Smoking Prevalence % Estimated No. Adults 16+Smokers 16 - 24536436%1931 25 - 34745038%2831 35 - 44855034%2907 45 - 54725230%2176 55 - 64660024%1584 65 - 74438418%789 75+304710%305 Erewash PCT: Estimated smoking prevalence by age (Women) Age group Female Est.Smoking Prevalence % Estimated No. Adults 16+Smokers 16 - 24525736%1893 25 - 34789635%2764 35 - 44863430%2590 45 - 54722228%2022 55 - 64640323%1473 65 - 74486418%876 75+531710%532

16. Erewash PCT: Estimated smoking prevalence by in Electoral Wards CAS Ward NamePopulationEstimated SmokingEstimated Prevalence %No. Smokers Little Eaton and Breadsall295415.7464 Sandiacre North349325.7898 Ockbrook And Borrowash588817.81048 Old Park321835.71147 Draycott316521.5680 Ilkeston Central355035.41257 Sandiacre South353217.3612 Sawley536825.21353 Nottingham Road503028.01407 Derby Road East377729.81124 Long Eaton Central482525.01204 Kirk Hallam505729.01468 West Hallam and Dale Abbey412114.2587 Cotmanhay349435.41236 Stanley172820.0346 Breaston371314.9554 Ilkeston North309536.11117 Little Hallam330917.6584

17. DH/NatCen ward-level “synthetic estimates” Dept of Health project Using data from the Health Survey for England Multivariate modelling to identify social and demographic predictors of smoking Ward-level estimates based on known social and demographic characteristics of ward populations Validated against local surveys in London and N.W. England Publication date – July 29 th 2005 –adult smoking –adult binge drinking –adult obesity –adult fruit and veg consumption –child fruit and veg consumption

18. West Midlands Regional Lifestyle Survey 2005 West Midlands Public Health Observatory

19. West Midlands Regional Survey 2005 Coordinated by WMPHO. Delivered by BMG. 56 funding partners including PCTs, LAs, GO, LSCs, Police Sampling frame = Public Access Electoral Register Self-completion questionnaire sent to 174,000 adults aged 18 and over Overall response rate = 33.1% The survey “ has fostered partnership working”

20. A local health survey: 1999 and 2002 Erewash Health Surveys

21. Erewash Health Survey: Design two age groups (25-34 & 65-74) two samples compared: –a random sample of all residents –a random sample of residents of the most deprived areas (Sawley, Cotmanhay and Kirk Hallam ) postal questionnaire

23. Erewash Health Survey 1999: Response People aged 25-34 –menrepresentative38% –womenrepresentative59% –mendeprived areas33% –womendeprived areas50% People aged 65-74 –menrepresentative82% –womenrepresentative81% –mendeprived areas83% –womendeprived areas76%

24. Lifestyle data from general practice potential source for data on smoking and obesity... but not (yet) other aspects of lifestyle LDP reporting obligations - current focus is still data quality QOF provides some financial incentives for improved data collection but scheme is essentially voluntary unregistered and non-attenders (incl some vulnerable groups) not represented QPID will provide summaries of prevalence at practice level but not (yet) for geographically defined populations the source of the future??

25. Lifestyle data from commercial market research organisations e.g. CACI, Claritas, Experian, Acxiom incl. smoking, expenditure on food and drink, obesity large volumes of household survey and consumer data modelled to provide estimates for all areas of the country methodologies obscure expensive

26. General Issues for Data Collection Systems Validity: does the system measure what it aims to measure? Reliability: –do questions produce reproducible answers? –inter-observer differences –recall of past events Comparability... e.g. vs neighbouring areas Timeliness Accuracy of data capture/data entry Cost Particular Issues for “Censuses” Completeness Particular Issues for Sample Surveys Bias – is the sample representative of the target population? Precision - is the sample size adequate?

27. Horses for courses: different systems suit different purposes Compare between localities Track progress on LPSA/LAA targets and Local Delivery Plans (LDPs). Outcome measures for services

28. Relevant current APHO projects 1.Review of sources of lifestyle data 2.Child Obesity measurement (Task Force project) 3.Community Profiles (Task Force project) 4.Lifestyle Survey Toolkit