Demography Domain

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Association of Public Health Observatories

Guidance on Joint Strategic Needs Assessment

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N/A 01 Jul 2008

PCT CEs, NHS Trust CEs, SHA CEs, Care Trust CEs, Foundation Trust CEs , Medical Directors, Directors of PH, Directors of Nursing, Local Authority CEs, Directors of Adult SSs, PCT PEC Chairs, Directors of Finance, GPs, Directors of Children's SSs, PCT and LA Directors of Commissioning and Directors of Finance, Regional Directors of the Government Offices

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The Department of Health have commissioned the Association of Public Health Observatories to undertake a review of the JSNA process. The core dataset is cross-tabulated against Vital Signs and the National Indicator Set. 10262

For Information

For Recipient's Use

The JSNA Core Dataset

YO10 5DD

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01904 724488 Anne Cunningham

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The Core Dataset

The core dataset in Table 1 provides an indicative list of indicators to assist partnerships in preparing their JSNA. Further information on each indicator is provided either within this document or in the official ‘Handbook of Definitions’ for the National Indicator Set.

Domains

The domains and sub-domains in the dataset are not official categories.

Demography Domain

The ‘Demography’ domain underpins the JSNA, both by setting local context, and as an essential component in producing projections and breakdowns of need.

Other Domains

The remaining domains, sub-domains and sub-sub-domains contain indicators which either measure need or are a proxy for it. Some of them relate to a particular age-group, as indicated by ticks in the ‘Children & Young People’ or ‘Older People’ column.

Projections

The first indicator in Table 1, ‘Population numbers’, specifies projected as well as estimated figures. This is partly to stress the particular importance of population

projections, without which many other projections would not be possible. It also serves as a general reminder of the need to forecast ahead.

Rather than repeat this every time, there is an implicit assumption that a selection of other indicators from across all the domains will also be projected forwards. Simple techniques suitable for forecasting many of the indicators are described in Projection methods for use in JSNA. Sometimes ‘ready-made’ projections are available, and where known about these are mentioned in the Further Information for each indicator.

Inequalities

Demographic indicators which could provide a useful breakdown for the study of

inequality in other indicators are marked with a tick in the ‘Crosstabulation’ column. For instance, a particular need may be higher or lower in certain age-groups or ethnic groups, among disabled people, or in deprived areas. Methods of analysing and expressing inequalities in health and wellbeing are described in Measuring Health Inequalities. The Further Information sections signposts any existing inequalities analyses that are known about. Measuring Equality at a Local Level (launching during summer 2008 at

www.idea.gov.uk/diversity) also sounds highly relevant, and promises new resources on:

• equality and neighbouhood statistics; • disaggregation of national data; and

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[image:4.595.45.564.79.759.2]

Table 1: Core Dataset for Joint Strategic Needs Assessment

Domain

Sub-domain Indicator

Cross-tabulate

?

See Page

Population numbers

Estimated and projected population by

age-band and gender 9 7

Births Current births 8

Ethnicity Estimated population by ethnic group 9 8

Disability Estimated number of disabled people, overall

and/or by impairment group 9 9

Religion Estimated population by religious group 9 11

Migrant

population Estimated population by migrant status 9 12

Number of households 14

Breakdown of area into constituent

communities/neighbourhoods 9 14

Deprivation band 9 14

ONS classification 9 15

Social marketing categories 9 15

De

mogr

aphy

Local area

Urban / rural classification 9 16

Domai

n

Sub-domain

Sub-sub-domain

Gener

a

l

Population Children &

Young Peopl

e

O

ld

e

r

People

Indicator

(Bold = National Indicator and/or Vital Sign)

See

Page

Poverty 9 Proportion of children in poverty (NI

116) NI defn

9 Housing tenure 17

9 Overcrowding 18

9 Adults with learning disabilities in settled accommodation (NI 145 and Vital Sign VSC05)

NI defn

9

Adults in contact with secondary mental health services in settled accommodation (NI 149 and Vital Sign VSC06)

NI defn

9 Living alone 18

Housing

9 Central heating 19

Living arrange-ments

Transport 9 Access to car or van etc 19

9 Overall employment rate (NI 151) NI defn

9 Working age people on out-of-work _{benefits (NI 152)} NI defn

9 Working age people claiming out-of-work benefits in the worst performing neighbourhoods (NI 153)

NI defn

Social and Environ

m

en

ta

l Conte

x

t

Economic Employment

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Domai

n

Sub-domain

Sub-sub-domain

Gener a l

Population Children &

Young Peopl e O ld e r People

Indicator

(Bold = National Indicator and/or Vital Sign)

See

Page

9

Adults in contact with secondary mental health services in

employment (NI 150 and Vital Sign VSC08)

NI defn

9 Unemployment rate 20

Employment (continued)

9 Claimant count 20

Economic (continued)

Other 9 Average incomes 21

Environ-ment Isolation 9 Access to services 21

Social and Environ

m en ta l Con tex t (co n tinued )

Voice Satisfaction 9 Satisfaction of people over 65 with

home and neighbourhood (NI 138) NI defn

9 Modelled and/or recorded smoking

prevalence 22

Smoking

9 Quit rates (NI 123 and Vital Sign

VSB05) NI defn

9 Modelled and/or recorded eating _behaviour 22

Eating habits

9 Prevalence of breastfeeding at 6-8 weeks from birth (NI 53 and Vital Sign VSB11)

NI defn

9 Alcohol-harm related hospital admission rates (NI 39 and Vital Sign VSC26)

NI defn

Alcohol

9 Modelled and/or recorded drinking _behaviour 23

Physical

activity 9

Participation in sport and active

recreation 23

9 Under 18 conceptions (NI 112 and _{Vital Sign VSB08)} NI defn

Behaviour

Teenage pregnancy

9 Under 16 conceptions ₂₄

Hypertension 9 Modelled and/or recorded hypertension 24

9 9 Modelled and/or recorded obesity (adult) 25

9 Obesity among primary school age children in Reception Year (NI 55 and Vital Sign VSB09)

NI defn Lifes tyle/Ris k Factors Other Obesity

9 Obesity among primary school age children in Year 6 (NI 56 & Vital Sign VSB09)

NI defn

9 All-Age All-Cause Mortality (NI 120

and Vital Sign VSB01) NI defn

9 Infant mortality 26

9 Life expectancy 26

9 Main causes of death 27

9 Hospital admissions – top 10 causes 28

Burden of ill-heal

th

Misc All causes

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Domai

n

Sub-domain

Sub-sub-domain

Gener

a

l

Population Children &

Young Peopl

e

O

ld

e

r

People

Indicator

(Bold = National Indicator and/or Vital Sign)

See

Page

All causes

(continued) 9

Healthy life expectancy at age 65 (NI 137 and Vital Sign VSC25)

NI defn &

28

Causes considered amenable to healthcare

9 Mortality rate from causes considered amenable to healthcare (Vital Sign VSC30)

29

Misc (continued)

Due to

smoking 9 Deaths attributable to smoking 29

9 Modelled v. recorded prevalence 30

Diabetes General

9 Estimated excess deaths among people

with diabetes 30

General 9

Mortality rate from all circulatory diseases under 75 (NI 121 and Vital Sign VSB02)

NI defn

9 Mortality 31

9 Modelled v. recorded prevalence 31 9 Hospital admission rate for MI (proxy for

incidence) 32

Coronary heart disease

9 Admissions for cardiac _{revascularisation} 32

9 Mortality 32

Circulatory

Stroke

9 Hospital admission rate for stroke _{(proxy for incidence)} 33

General 9 Mortality rate from all cancers under

age 75 (NI 122 and Vital Sign VSB03) NI defn

Cancer

By site 9 Cancer registrations 33

9 COPD mortality 34

Respir-

atory COPD ₉ _{COPD modelled v. recorded prevalence} ₃₄

TB 9 TB notifications 35

9 KC60 GUM STI data, particularly _gonorrhoea 35

9 New diagnoses of HIV/Aids 36

9 Late diagnoses of HIV/Aids 36

Infectious

STIs & HIV

9 Uptake of Chlamydia screening in under-25s (NI 113 and Vital Sign VSB13)

NI defn

Dental

health Decay 9 % dmft in 5-year olds 37

Dementia 9 Prevalence of dementia 37

th (continued)

Mental

health Suicide 9

Suicide and injury of undetermined intent mortality rate (Vital Sign

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Domai

n

Sub-domain

Sub-sub-domain

Gener a l

Population Children &

Indicator

(Bold = National Indicator and/or Vital Sign)

See

Page

Mental

health cont. Mental illness 9

Mental illness needs indices and

prevalence rates 38

Falls 9 Hospital admissions for fractured

proximal femur (proxy for incidence) 39 9 People killed or seriously injured on _roads 39

Road accidents

9 Children killed or seriously injured _{on roads (NI 48)} NI defn

Trauma

Injuries 9

Hospital admissions caused by unintentional and deliberate injuries to children and young people (NI 70 and Vital Sign VSC29)

NI defn

th (continued)

Musculo-skeletal Arthritis 9

Admissions for hip and knee

replacement 39

9 9

Physical disability, frailty and sensory impairment

1. Number of clients

2. Number receiving services in community

40

9 9

Learning disability 1. Number of clients

40

9 9

Mental health

1. Number of clients

40

9 9

Substance misuse 1. Number of clients

40

Numbers

9 9

Vulnerable people 1. Number of clients

40

9

Timeliness of social care

assessment (NI 132 and Vital Sign VSC12) and packages (NI 133 and Vital Sign VSC13)

NI defn

9

People supported to live independently through social services (NI 136 and Vital Sign VSC03) NI defn Services Social care Standard of service 9

Carers receiving needs assessment or review and a specific carer’s service, or advice and information (NI 135)

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Domai

n

Sub-domain

Sub-sub-domain

Gener a l

Population Children &

Indicator

(Bold = National Indicator and/or Vital Sign)

See

Page

Social care (continued) Standard of service (continued) 9

Adults and older people receiving direct payments and/or individual budgets per 100,000 population aged 18 and over (Vital Sign VSC17, NI 130)

NI defn

Maternity 9 Early access for women to maternity

services (NI 126, Vital Sign VSB06) NI defn

Dental health 9 Number of people accessing NHS

dentistry (Vital Sign VSB18) 41

9 Uptake rates for flu jab 41

9 Proportion of children who complete immunisation by recommended ages (Vital Sign VSB10)

41

Preventative / screening

9 Proportion of women aged 47-49 and 71-73 offered screening for breast cancer (Vital Sign VSA09)

42

9 Offer of an appointment at a GUM _{service within 48 hours} 42

9 Long acting reversible contraception _methods 43

Sexual health

9 Access to NHS funded abortions before _{10 weeks gestation} 43

Mental health 9

Proportion of people with depression and/or anxiety disorders who are offered psychological therapies (Vital Sign VSC02)

44

Health services

Long-term

conditions 9

Proportion of people with long-term conditions supported to be

independent and in control of their condition (NI 124, Vital Sign VSC11)

NI defn

9 The extent to which older people receive the support they need to live independently at home (NI 139)

NI defn

9 User reported measure of respect and dignity in their treatment (NI 128 and Vital Sign VSC32)

NI defn

User perspective on social care

9 Self-reported experience of social _{care users (NI 127)} NI defn

9 National Patients Survey Programme _{findings for local institutions} 46

9 Parental experience of services for disabled children (NI 54, Vital Sign VSC33)

NI defn

9 Patient experience of access to _{primary care (Vital Sign VSA06)} 45

Services (co n tinued ) Voice User perspective on health care

9 User reported measure of respect and dignity in their treatment (NI 128 and Vital Sign VSC32)

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Further information to support Table 1

Indicator(s)

1.

Estimated population by age-band and gender

Domain Sub-domain Sub-sub-domain

Demography Population numbers N/A Sources

Description Detail

Available

from

http://www.statistics.gov.uk/StatBase/Product.asp?vln k=601

(Look for ‘Population Estimates – Current Datasets’) ONS mid-year

population estimates

LA level, latest 2006

http://www.statistics.gov.uk/statbase/product.asp?vlnk =14060 for more detailed age-breakdowns etc

http://www.statistics.gov.uk/StatBase/Product.asp?vln k=14357

ONS mid-year population estimates (experimental)

LSOA and MSOA level, latest 2005

Also available from

www.neighbourhood.statistics.gov.uk – Choose ‘People and Society: Population and Migration’, then: • ‘Resident Population Estimates, All

Persons/Females/Males’ (down to MSOA level), or

• ‘Resident Population Estimates by Broad Age Band’ (down to LSOA level)

http://www.statistics.gov.uk/STATBASE/Product.asp? vlnk=997

Use ‘2006-based SNPP – Current Data’ for a pdf interface to the Excel tables, or ‘2006 – based SNPP – Datasets’ to download the tables themselves.

Previous 2004-based projections are also available from POPPI (www.poppi.org.uk) for age-groups 65+

Projections

ONS

Subnational Population Projections

LA level, 2004-based projections

for 2006-31 Previous 2004-based projections are also available via user-friendly tool at

http://www.swpho.nhs.uk/resource/view.aspx?RID=35 108 (see

http://www.swpho.nhs.uk/resource/view.aspx?RID=35 086 for introduction).

Comments

NB – the ONS projections also provide a breakdown of how much of each year’s change is natural (due to births and deaths), and how much due to migration. To see this, choose one of the tables called ‘components of change’ (i.e. Table 6 for Las, counties and

Government Office Regions).

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Return to Table 1

Indicator(s)

2.

Current births

Domain Sub-domain Sub-sub-domain

Demography Births N/A Sources

Description Detail

Available

from

[image:10.595.65.559.92.723.2]

ONS Vital Statistics Tables VS1

& VS2 (LA level) Birth rates

and numbers

[image:10.595.72.557.452.702.2]

ONS Vital Statistics Table VS4 (ward level)

See http://www.ons.gov.uk/about/who-we- are/our-services/unpublished-data/vital-events-data/vso--non-nhs-customers for how to obtain Vital Statistics if you are not an NHS customer.

Comments

• For a description of the Vital Statistics tables available to non-NHS customers, see http://www.esds.ac.uk/government/vitals/datasets/. However the table at the bottom referred to as ‘VS4DL’ should say ‘VS4D’, and the table referred to as ‘VS4D’ should say ‘VS4’.

• For a useful presentation on the Vital Statistics, see

http://www.ccsr.ac.uk/esds/events/2006-07-05/slides/norman.ppt. (Please note that Table VS5 is no longer available to local authorities).

Indicator(s)

3.

Estimated population by ethnic group

Domain Sub-domain Sub-sub-domain

Demography Ethnicity N/A Sources

Description Detail

Available

from

http://www.statistics.gov.uk/StatBase/Product .asp?vlnk=14238&Pos=1&ColRank=1&Rank =272

ONS Population Estimates by Ethnic Group (experimental)

LA level, 2001-2005

Also available from

www.neighbourhood.statistics.gov.uk – Choose ‘People and Society: Population and Migration’, then ‘Resident Population

Estimates by Ethnic Group’. Comments

• Projections only available if specially commissioned or calculated.

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Return to Table 1

Indicator(s)

4.

Estimated number of disabled people, overall and/or by impairment group

Domain Sub-domain Sub-sub-domain

Demography Disability N/A Sources

Description Detail

Available

from

Disability Discrimination Act (DDA) definition

Suggested definition for use in local surveys

Only available by local survey. See Appendix 1 for background information and approved question wording.

Impairment groups are:

• physical impairment

• sensory impairment

• mental health condition

• learning disability

• other long-standing illness / health condition

Health Survey for England 2001

http://www.archive2.official-documents.co.uk/document/deps/doh/survey 01/disa/disa01.htm. National prevalences which could be applied to local population data. Scroll down for tables -e.g. Table 1 gives prevalence of moderate and severe disability by age-group (16+) and sex. Overall

disability by

severity Local estimates (based on Survey of Disability in Great Britain 1988)

‘Capacity to Change’ Table 2

(http://www.jitscotland.org.uk/uploads/paneld

ocs/JIT-Commissioning-Workbook-Tables.xls) generates disability estimates and projections if relevant local population data is entered in preceding tables. Mainly focuses on older people.

Limiting

long-term illness Census 2001

From usual Census sources – e.g. www.neighbourhood.statistics.gov.uk,

www.nomisweb.co.uk. Not the same thing as disability, but may be useful as a proxy. People

registered blind and partially sighted

Latest figures 2006, LA level

From Information Centre, at

http://www.ic.nhs.uk/statistics-and-data- collections/social-care/adult-social-care- information/people-registered-as-blind-and-partially-sighted-triennial-2006-england.

Learning Disabilities

QOF 2005-06, down to PCT and practice level

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Indicator(s)

4.

Simple estimates

A simple guide to estimating local populations of people with learning disabilities can be found at

http://valuingpeople.gov.uk/echo/filedownloa d.jsp?action=dFile&key=1111

National estimates of prevalence

Prevalence estimates available from:

http://www.lancs.ac.uk/fass/ihr/research/lear ning/download/currentneed.pdf

The same team at Lancaster University has produced a new report for Mencap,

summarising nationally representative statistics on various aspects of learning disability:

http://www.mencap.org.uk/displaypagedoc.a sp?id=3160

Learning disabilities

National projections of prevalence

Available from:

www.lancs.ac.uk/fass/ihr/research/learning/d ownload/futureneed.pdf. See also report at www.mencap.org.uk/displaypagedoc.asp?id= 3160

Down’s Syndrome Visual impairment Mobility problems Limiting long-term illness

LA-level projection for older people

www.poppi.org.uk

Projections

Overall disability by severity

Local estimates (based on Survey of Disability in Great Britain 1988)

‘Capacity to Change’ Table 2

(http://www.jitscotland.org.uk/uploads/paneld

ocs/JIT-Commissioning-Workbook-Tables.xls) generates disability estimates and projections if relevant local population data is entered in preceding tables. Mainly focuses on older people.

Inequalitie

s Aspects Disability and employment

LA estimates from Annual Population Survey / Labour Force Survey

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Indicator(s)

4.

Comments

• For a 4-page guide to different definitions of disability from the DWP, see http://www.dwp.gov.uk/asd/asd5/ih2003-2004/IH128userguide.pdf.

• Work is ongoing at Manchester University to produce improved local estimates and projections of numbers of disabled people – see

http://www.ccsr.ac.uk/popgroup/disability.htm

• For more in-depth discussion of various scenarios regarding projected numbers of disabled people, see e.g. the ‘Trends’ section in each chapter of:

http://www.ippr.org.uk/members/download.asp?f=%2Fecomm%2Ffiles%2FDisability %5F2020%5Ffull%2Epdf.

• Two publications which look at the broad area of inequalities affecting disabled people are:

o Purdam, K et al (2008). Disability in the UK: measuring equality. Disability &

Society, 23:1, 53-65. Available from http://dx.doi.org/10.1080/09687590701725658

o Parckar, G (2008). Disability Poverty in the UK. London, Leonard Cheshire Disability. Available from http://www.lcdisability.org/?lid=6386

Return to Table 1

Indicator(s)

5.

Estimated population by religious group

Domain Sub-domain Sub-sub-domain

Demography Religion N/A Sources

Description Detail

Available

from

Religion 2001 Census

Usual Census sources – e.g.

http://www.neighbourhood.statistics.gov.uk/, www.nomisweb.co.uk.

Comments

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Indicator(s)

6.

Estimated population by migrant status

Domain Sub-domain Sub-sub-domain

Demography Migration N/A Sources

Description Detail

Available

from

Total

International Migration (TIM)

LA level (flows)

Latest estimated international inflow & outflow are in the ‘Components of Change’ sheet for each LA at

http://www.statistics.gov.uk/statbase/product. asp?vlnk=14060..

Foreign NI Number (NINO) registrations

LA level

Tables downloadable from

http://www.dwp.gov.uk/asd/asd1/niall/nino_al location.asp

For those with a ‘.gov.uk’ email address, LA-level data available from

http://www.lgar.local.gov.uk/lgv/core/page.do ?pageId=27879.

Regional data available from

http://www.bia.homeoffice.gov.uk/sitecontent/ documents/aboutus/Reports/accession_moni toring_report/

Workers Registration Scheme (WRS)

Only applies to A8

countries.

LA-level upwards.

WRS-based estimates of A8 workers per 1000 residents at LA level - Appendix B of IPPR report ‘Floodgates or Turnstiles?’ at http://www.ippr.org.uk/members/download.as p?f=%2Fecomm%2Ffiles%2Ffloodgates%5F or%5Fturnstiles%2Epdf. Also in map form at http://news.bbc.co.uk/1/hi/uk/7370955.stm. ‘Flag 4’

marker on Patient

Register Data System

Identifies in-migrants registering with GP.

Mid-2006 LA-level ‘Flag 4’ data available at http://www.statistics.gov.uk/about/data/metho dology/specific/population/future/imps/update s/downloads/AppA.xls. See metadata sheet in this file for explanation of ‘Flag 4’ marker. Pupil Level

Annual School Census (PLASC)

LEA level

Available from individual Local Education Authorities. Only reflects those in-migrants who bring their children with them. Relies on use of ‘first language other than English’ as a proxy for immigration.

Projection

Total

International Migration (TIM)

LA level (flows)

International inflow & outflow for each LA to 2029 are available at

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Indicator(s)

6.

Estimated population by migrant status

Comments

Each of the above data sources has its strengths and weaknesses. Discussion and examples of their use can be found at the following addresses:

• Audit Commission: http://www.audit-commission.gov.uk/migrantworkers/

See especially ‘Local data and intelligence’. Its four sub-sections cover the above (and other) national data sources, ideas for gathering and exploiting local data, and a useful guide to what data will help you to answer what question.

• Office for National Statistics:

http://www.statistics.gov.uk/about/data/methodology/specific/population/future/imps/u pdates/default.asp. See particularly a review of administrative data sources at

http://www.statistics.gov.uk/about/data/methodology/specific/population/future/imps/u pdates/downloads/admin.pdf.

• Local Government Analysis and Research (LGAR):

http://www.lgar.local.gov.uk/lgv/core/page.do?pageId=42487. See especially the ‘Sources of research and information….’ section. Resources include:

o A 5-page guide to ‘Sources of information on migration’ at http://www.lgar.local.gov.uk/lgv/aio/35288;

o A report commissioned from the Institute of Community Cohesion (ICoCo) on ‘estimating the scale and impacts of migration at the local level’

(http://www.lgar.local.gov.uk/lgv/core/page.do?pageId=42490);

o A 4-page leaflet following on from the ICoCo report, and called ‘where have recent in-migrants gone?’ (http://www.lgar.local.gov.uk/lgv/aio/67211).

• Greater London Authority:

http://www.london.gov.uk/gla/publications/factsandfigures/dmag-briefing-2008-10.pdf

Inequalities Aspects

As well as issues of enumeration, the Audit Commission and LGAR sites, and the ICoCo report, all provide advice on how to understand the impact of migration upon local

services, and the challenges faced by the in-migrants themselves, illustrated by local case studies.

Some of the social, economic and health issues particularly affecting migrants are

summarised in a paper on Migrant Health in North East England by the North East Public Health Observatory (http://www.nepho.org.uk/view_file.php?c=2679). A study in Fife can be found at www.fifedirect.org.uk/migrantsurvey.

Further ideas for local research were presented at a LARIA/LGA event in May 2007 (see report at http://www.laria.gov.uk/content/features/85/feat6.pdf or slides at

http://www.laria.gov.uk/content/articles/migrant_workers_10052007/migrant_workers_10 052007.htm).

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Return to Table 1

Indicator(s)

7.

Number of households

Domain Sub-domain Sub-sub-domain

Demography Local area N/A Sources

Description Detail

Available

from

Number and type of households

Regional, to 2029

http://www.communities.gov.uk/documents/h ousing/xls/707895.xls

Projections Number of _households LA level, to ₂₀₂₉ http://www.communities.gov.uk/documents/h_{ousing/xls/707899.xls}

Comments

Indicator(s)

8.

Breakdown of area into constituent communities/neighbourhoods

Domain Sub-domain Sub-sub-domain

To be determined locally. Comments

Refers to any defined localities (neighbourhoods, towns etc) which may form a natural reporting unit for any of the indicators.

Indicator(s)

9.

Deprivation band

Domain Sub-domain Sub-sub-domain

Description Detail

Available

from

Indices of Deprivation 2007

Lower level SOA

http://www.communities.gov.uk/communities/ neighbourhoodrenewal/deprivation/deprivatio n07/

Comments

• The Index of Multiple Deprivation (IMD), or other constituent elements of the Indices of Deprivation, can be used to allocate local LSOAs to a deprivation quintile.

• Although it is not officially approved, the deprivation indices can be derived for larger areas by taking a weighted average. For example, the 2007 Health Profiles contained MSOA-level averages and quintiles based on the 2004 Income Deprivation index (http://www.communityhealthprofiles.info/indicators/datasets/Deprivation_quintiles.xls) The 2008 Health Profiles will contain a similar MSOA-level summary of the IMD 2007.

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Indicator(s)

10.

ONS classification

Domain Sub-domain Sub-sub-domain

Description Detail

Available

from

http://www.statistics.gov.uk/about/methodolo gy_by_theme/area_classification/

National Statistics 2001 Area Classification

Available for LAs, Health areas,

Wards, SOAs and Output Areas

Also available from

www.neighbourhood.statistics.gov.uk

Comments

• This classification allocates each local authority, ward, SOA etc to clusters, known as ‘Supergroups’, ‘Groups’ and ‘Subgroups’, with names such as ‘Disadvantaged Urban Communities’ or ‘Countryside Communities’. Areas in the same cluster will have similar census characteristics.

Indicator(s)

11.

Social marketing categories

Domain Sub-domain Sub-sub-domain

Description

Detail

(spatial level)

Available from

Personicx Geo

Unit

Postcode Axciom (www.acxiom.co.uk)

Mosaic UK

Unit

Postcode / LSOA

Experian (www.experian.co.uk)

People and

Places OA / LSOA

Beacon Dodsworth ( www.beacon-dodsworth.co.uk)

ACORN Unit

Postcode CACI (www.caci.co.uk) Health

ACORN OA CACI (www.caci.co.uk) Comments

• If you have access to one of these products, it can be used instead of the ONS Classification to identify homogeneous sub-areas for analysis and comparison.

• People & Places can also be supplied by postcode, but all postcodes within an OA receive the same classification.

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Return to Table 1

Indicator(s)

12.

Urban/rural classification

Domain Sub-domain Sub-sub-domain

Description Detail

Available

from

ONS Rural & Urban Area Classification 2004

At OA, LSOA, MSOA and Ward level

http://www.statistics.gov.uk/geography/nrudp .asp

(Also described on DEFRA site below, but data not available there.)

http://www.defra.gov.uk/rural/ruralstats/rural-definition.htm

DEFRA LA Classification 2005

(less relevant – see below)

LA level _{Results also tabulated at}

http://www.poverty.org.uk/summary/rural%20 intro.shtml (scroll down).

Comments

• See http://www.poverty.org.uk/summary/rural%20intro.shtml for a quick introduction. • The LA Classification is probably less relevant for JSNA: “We do not recommend that

the classification is used to inform detailed policy design (e.g. for targeting local service delivery).” [DEFRA]

(19)

Indicator(s)

13.

Housing tenure

Domain Sub-domain Sub-sub-domain

Social & Environmental Context

Living Arrangements Housing

Sources

Description Detail

Available

from

From usual Census sources – e.g. www.neighbourhood.statistics.gov.uk, www.nomisweb.co.uk.

2001 Census data

Down to OA

level _{Census data on Tenure by Age from Table} S017 is also available for Older People only and at LA level only from www.poppi.org.uk. http://www.communities.gov.uk/housing/hous ingresearch/housingstatistics/housingstatistic sby/localauthorityhousing/dataforms/.

Choose desired year, then click on link to HSSA data and choose relevant region. Tenure data is usually on the first sheet. Available up to 2006/07 as of April 2008. HSSA data

(Housing Strategy Statistical Appendix)

LA level only

Also available from

www.neighbourhood.statistics.gov.uk, but only up to 2005/06 as of April 2008. Go to ‘Housing’ domain and choose ‘Dwelling Stock by Tenure and Condition’.

Council Tax Records

Sub-LA level (some LAs only)

Tenure is recorded on some, but not all, local authority Council Tax systems.

Comments

• Census data is the only source which distinguishes between Private Rented and Owner Occupied.

• NB – when obtaining Tenure from Census tables, it is important to note whether the unit of analysis is the household or the individual.

(20)

Indicator(s)

14.

Overcrowding

Domain Sub-domain Sub-sub-domain

Sources

Description Detail

Available

from

2001 Census data

Down to OA level

From usual Census sources – e.g. www.neighbourhood.statistics.gov.uk, www.nomisweb.co.uk. Look for ‘Occupancy Rating’ or ‘Persons per Room’.

Comments

• The most relevant Census variable is Occupancy Rating, which is defined at

http://www.neighbourhood.statistics.gov.uk/dissemination/LeadMetadataDownloadPD F.do?downloadId=188. It takes account not only of the number of persons, but their relationships, genders and ages, to determine what would be an appropriate number of rooms. A negative Occupancy Rating means too few rooms – i.e. overcrowding. • ‘Persons per Room’ is also available from the Census but is a cruder measure.

Indicator(s)

15.

Living alone (older people)

Domain Sub-domain Sub-sub-domain

Sources

Description Detail

Available

from

2001 Census data

Down to OA level

Projection

Numbers of older people living alone

Projections to 2025, LA level only

From www.poppi.org.uk

Comments

• Census defines a ‘pensioner’ as Male 65+ or Female 60+. Tables providing

[image:20.595.76.554.384.722.2]

information on ‘pensioners’ living alone include ‘Household Composition – People’ (UV46) from Neighbourhood Statistics. If wishing to use a different definition of ‘Older People’, could look at ‘Living alone’ row and ‘Age’ column of table CAST05 (‘Theme table on all people’), available on Nomis.

(21)

Return to Table 1

Indicator(s)

16.

Central heating (older people)

Domain Sub-domain Sub-sub-domain

Sources

Description Detail

Available

from

OA level upwards

www.nomisweb.co.uk. E.g. see Theme Table T06 on ‘Pensioner Households’.

2001 Census data

LA level only www.poppi.org.uk

Comments

• NB - Not available from Neighbourhood Statistics, as Census tables there do not give breakdown by age.

Indicator(s)

17.

Access to car or van etc

Domain Sub-domain Sub-sub-domain

Living Arrangements Transport

Sources

Description Detail

Available

from

OA level upwards

2001 Census data

LA level only www.poppi.org.uk (‘Pensioner Households’ only)

Comments.

(22)

Indicator(s)

18.

Unemployment rate

Domain Sub-domain Sub-sub-domain

Economic Employment

Sources

Description Detail

Available

from

ONS surveys

and models LA level

www.nomisweb.co.uk. Easiest to use the ‘Local authority’ profiles available under ‘Summary Statistics’ on home page.

2001 Census

Available below LA level

www.nomisweb.co.uk. For wards, easiest to use the ‘Ward’ profiles available under ‘Summary Statistics’ on home page.

Comments.

• By ‘unemployed’, ONS means the International Labour Organisation definition:

o Without a job, want a job, have actively sought work in the last 4 weeks and are

available to start work in the next 2 weeks, or

o Out of work, have found a job and are waiting to start it in the next 2 weeks

• This can only be ascertained by survey. It is not the same thing as the claimant count. • To express as a rate, the count is divided by the number of economically active. • Even at LA level, sample sizes are small, so ONS has developed more reliable

model-based estimates. Below LA level, the only available data is from the Census. • The LA and Ward profiles in Nomis will automatically select the latest and most

appropriate unemployment data for the chosen area.

• By exploring the ‘Annual Population Survey’ in Nomis it is possible to find limited ethnic breakdowns, e.g. ‘16+ unemployment rate non-white’. However these often have large confidence intervals (e.g. +/- 10% for Bradford) or are suppressed.

Return to Table 1

Indicator(s)

19.

Claimant count

Domain Sub-domain Sub-sub-domain

Economic Employment

Sources

Description Detail

Available

from

Latest data from ONS

LA and ward level

www.nomisweb.co.uk. Easiest to use the ‘Local authority’ or ‘Ward’ profiles available under ‘Summary Statistics’ on home page.

Comments.

• ‘Claimant count’ refers to the count of those claiming Job Seekers Allowance (JSA). This is not the same as all those who are unemployed, and does not require a survey. • To express as a rate, the count is divided by the working-age population.

(23)

Indicator(s)

20.

Average incomes

Domain Sub-domain Sub-sub-domain

Economic Other

Sources

Description Detail

Available

from

ONS Model-based estimates

MSOA level, 2004

www.neighbourhood.statistics.gov.uk. Look for ‘Income: Model-based estimates’ in ‘People and Society: Income and Lifestyles’ domain.

Proprietary products – e.g. Paycheck

Unit

postcode www.caci.co.uk

Comments.

Indicator(s)

21.

Access to services

Domain Sub-domain Sub-sub-domain

Environment Isolation

Sources

Description Detail

Available

from

‘Geographical Barriers’ subdomain of Indices of Deprivation 2007

LSOA level scores

Go to

http://www.communities.gov.uk/communities/neig hbourhoodrenewal/deprivation/deprivation07/

and click on zip file called ‘Subdomains of the IMD 2007’. Look at the Geographical Barriers Subdomain score within ‘Barriers to Housing &

Services’. Remote places will have high positive

scores.

‘Geographical Barriers’ subdomain of Indices of Deprivation 2004

LSOA level distances to GP, primary school, post office and supermarket

The raw data behind the 2004 subdomain is on

www.neighbourhood.statistics.gov.uk (look for ‘Combined Road Distance to Services’ under ‘Indices of Deprivation and Classification’). The 2007 raw data may be expected to be added in due course.

DFT Core Accessibility Indicators 2005

LSOA level misc

indicators

http://www.dft.gov.uk/pgr/statistics/datatablespubl ications/ltp/coreaccessindicators2005.

‘Downloads’ on right-hand side of page gives access to a range of indicators on access to GPs, supermarkets, etc, with accompanying documentation.

Comments.

• DFT Core Accessibility Indicators may be over-technical for JSNA purposes.

(24)

Indicator(s)

22.

Modelled and/or recorded smoking prevalence

Domain Sub-domain Sub-sub-domain

Lifestyle/risk factors Behaviours Smoking Sources

Description Detail

Available

from

Survey data on smoking prevalence

Local

Currently only available if a local survey is conducted. Will in future be available from new Integrated Household Survey.

Available from

www.neighbourhood.statistics.gov.uk. Look for ‘Healthy Lifestyle Behaviours: Model-based estimates’ under ‘Health and Care’. Modelled

estimates of smoking prevalence

LA, PCT and MSOA, 2003-05

Also available (LAs only) from

http://www.ic.nhs.uk/pubs/healthylifestyles05 Data on

mothers smoking at time of delivery

PCT, quarterly

http://www.dh.gov.uk/en/Publichealth/Healthi mprovement/Tobacco/TobaccoGeneralInfor mation/DH_4139682

Comments

• Model-based estimates show what may be expected locally based on the area’s socio-economic characteristics, and cannot be used to monitor performance.

Indicator(s)

23.

Modelled and/or recorded eating behaviour

Domain Sub-domain Sub-sub-domain

Lifestyle/risk factors Behaviours Eating habits Sources

Description Detail

Available

from

Survey data

on prevalence Local Only available if a local survey is conducted. Available from

estimates of ‘5-a-day’ consumption

http://www.ic.nhs.uk/pubs/healthylifestyles05

Comments

(25)

Indicator(s)

24.

Modelled and/or recorded drinking behaviour

Domain Sub-domain Sub-sub-domain

Lifestyle/risk factors Behaviours Alcohol Sources

Description Detail

Available

from

Survey data

on prevalence Local Only available if a local survey is conducted. Available from

estimates of binge drinking

Comments

• Model-based estimates show what may be expected locally based on the area’s socio-economic characteristics, and cannot be used to monitor performance.

Indicator(s)

25.

Participation in sport and active recreation

Domain Sub-domain Sub-sub-domain

Lifestyle/risk factors Behaviours Physical activity Sources

Description Detail

Available

from

LA level

http://www.sportengland.org/index/get_resou rces/research/active_people/active_people_1 .htm provides link to Headline Results at LA level, and instructions for registering with the Active People Diagnostic tool to analyse LA results in greater depth.

Active People Survey

2005/06

MSOA level (modelled)

The above page also provides links to maps of model-based estimates of participation at MSOA level.

Comments

• Model-based estimates show what may be expected locally based on the area’s socio-economic characteristics, and cannot be used to monitor performance. • At the time of writing, the Active People Survey 2007/08 is under way – see

http://www.sportengland.org/index/get_resources/research/active_people/active_peop le_2.htm

(26)

Indicator(s)

26.

Under-16 conceptions

Domain Sub-domain Sub-sub-domain

Lifestyle/risk factors Behaviours Teenage pregnancy Sources

Description Detail

Available

from

Number and rate of under-16 conceptions

LA level, 2002-04

http://www.everychildmatters.gov.uk/_files/L A%20teenage%20pregnancy%20analysis%2 0v3.2%20(April%2007).xls (final three

columns of ‘LAD 1 data’ sheet).

Number and rate of under-16 conceptions

LA level, 2003-05 (provisional)

Held on EMPHO website

(www.empho.org.uk) but only available to certain registered users.

Comments

• EMPHO is the lead PHO for Teenage Pregnancy. Both www.empho.org.uk and http://www.everychildmatters.gov.uk/teenagepregnancy/ are also worth visiting in connection with the ‘Under 18 conceptions’ indicator.

Indicator(s)

27.

Modelled and/or recorded hypertension

Domain Sub-domain Sub-sub-domain

Lifestyle/risk factors Other Hypertension Sources

Description Detail

Available

from

Modelled hypertension prevalence

PCTs, 2006 (based on 2003/04 data)

www.apho.org.uk/apho/models.aspx

provides links to APHO hypertension model methodology and results. Click on ‘Modelled data for 2007/08 LDPs’ for summary results, or ‘Hypertension Model’ (under ‘Tools’) for more detail.

QOF data

PCTs and practices, 2006/07

Go to

http://www.ic.nhs.uk/our- services/improving-patient-care/the-quality- and-outcomes-framework-qof-2006/07/qof-2006-07-data-tables, scroll down to ‘PCT QOF Tables’ or ‘Practice QOF Tables’, and select the ‘Prevalence’ spreadsheet.

If unfamiliar with practice codes, click on the Practice Lookup Table link.

Comments

(27)

Indicator(s)

28.

Modelled and/or recorded obesity (adult)

Domain Sub-domain Sub-sub-domain

Lifestyle/risk factors Other Obesity Sources

Description Detail

Available

from

Available from

estimates of obesity

Survey data on obesity prevalence

Local Only available if a local survey is conducted.

QOF data –

Not

recommended (see below)

Go to

Pro

jection

Obesity in older people

LA level to

2025 From www.poppi.org.uk

Comments

• Model-based estimates show what may be expected locally based on the area’s socio-economic characteristics, and cannot be used to monitor performance. • http://www.yhpho.org.uk/resource/item.aspx?RID=9819 explains

shortcomings in the first year of QOF data on obesity, and recommends that it should not be used to measure prevalence.

• For child obesity, see separate indicators (NI 55 and 56).

(28)

Return to Table 1

Indicator(s)

29.

Infant mortality

Domain Sub-domain Sub-sub-domain

Burden of ill-health Misc All causes Sources

Description Detail

Available

from

Numbers and rates (< 1 yr, < 28 days, < 7 days)

LA and PCT level, 2006 or 2004-06

www.nchod.nhs.uk. Select ‘Go directly to the indicators’, and scroll down to ‘Mortality in Infancy’.

Comments

• It is theoretically possible for the PCT or PHO to calculate breakdowns by birthweight, gestation, deprivation etc, but in many cases numbers will be too small for this to be meaningful or publishable.

Indicator(s)

30.

Life expectancy

Domain Sub-domain Sub-sub-domain

Description Detail

Available

from

www.nchod.nhs.uk. Life

expectancy

LA and PCT level, up to

2003-05 http://www.statistics.gov.uk/downloads/them e_population/LE_E&W_2006.xls

Life

expectancy

Ward level 1999-2003

http://www.statistics.gov.uk/statbase/Product. asp?vlnk=14466 (Experimental Statistics)

Inequalitie

s

As

p

ects Life

expectancy

By

deprivation quintile within LA

Latest year’s APHO Health Profiles, at www.communityhealthprofiles.info

Comments

(29)

Indicator(s)

31.

Main causes of death

Domain Sub-domain Sub-sub-domain

Description Detail

Available

from

[image:29.595.71.558.123.413.2]

ONS Vital Statistics Tables VS3

(LA level); Number of

deaths by

cause ONS Vital Statistics Table VS4D

(ward level)

See http://www.ons.gov.uk/about/who-we- are/our-services/unpublished-data/vital-events-data/vso--non-nhs-customers for how to obtain Vital Statistics if you are not an NHS customer.

Approved list of cause groupings

Annex A, p12 of

http://www.statistics.gov.uk/articles/hsq/HSQ 28_death.pdf. See discussion below.

Comments

• There is no single ‘correct’ definition of this indicator, and different results will be obtained depending on the level of precision with which cause of death is defined. • ONS published an article in 2005 on the implications of different ways of grouping

leading causes of death (http://www.statistics.gov.uk/articles/hsq/HSQ28_death.pdf).

Annex A of that article suggested a possible list of cause groups.

• A subsequent consultation approved the use of this list, and it was implemented for the first time in a national report in summer 2006 (see pp 53ff of

http://www.statistics.gov.uk/downloads/theme_health/HSQ30.pdf, esp. Table 3 and Figure 3). A similar presentation of the top ten causes for males and females separately would be appropriate for JSNA.

• Vital Statistics Table VS3 at LA level allows the use of something closely

approximating the approved list of causes. It also permits analysis by age-group. • Vital Statistics Table VS4D at Ward level has a much broader categorisation of cause

of death (see www.esds.ac/government/vitals/datasets). It is important to note that these are not mutually exclusive nor exhaustive. There is also no age breakdown. • For a description of the Vital Statistics tables available to non-NHS customers, see

http://www.esds.ac.uk/government/vitals/datasets/. However the table referred to as ‘VS4DL’ should say ‘VS4D’, and the table referred to as ‘VS4D’ should say ‘VS4’. • For a useful presentation on the Vital Statistics, see

http://www.ccsr.ac.uk/esds/events/2006-07-05/slides/norman.ppt. (Please note that Table VS5 is no longer available to local authorities).

(30)

Return to Table 1

Indicator(s)

32.

Hospital admissions – top 10 causes

Domain Sub-domain Sub-sub-domain

Description Detail

Available

from

Yet to be defined

LA or PCT level

Forthcoming ‘APHO Standard Outputs’, based on Hospital Episode Statistics (HES).

Comments

• There is no single ‘correct’ definition of this indicator. Your own PHO may have calculated results for LAs or PCTs in your region (see relevant PHO website), but each has used a different approach.

• Work is under way to develop a joint ‘APHO Standard Outputs’ site for HES results, which it is hoped will include a consensus definition of this indicator.

Indicator(s)

33.

Healthy life expectancy at 65 (pending availability of official NI 137)

Domain Sub-domain Sub-sub-domain

Burden of ill-health Misc Causes considered amenable to healthcare Sources

Description Detail

Available

from

Healthy Life Expectancy at 65

LA and above, 2001 (revised)

http://www.statistics.gov.uk/downloads/them e_health/Health_Expectancies.xls. Go to sheet ‘HLA at 65 LAs’.

Comments

• The official indicator will be a new version based on the Place Survey.

(31)

Indicator(s)

34.

Mortality rate from causes considered amenable to healthcare

Domain Sub-domain Sub-sub-domain

Burden of ill-health Misc Causes considered amenable to healthcare Sources

Description Detail

Available

from

Directly standardised rate (<75)

LA and PCT level,

2004-06

www.nchod.nhs.uk. Look for ‘Mortality from causes considered amenable to healthcare’

Comments

• NCHOD provides documentation of what is meant by ‘causes considered amenable to healthcare’.

• For each age-group and time-period, NCHOD provides three spreadsheets. These contain the following variants:

1. Mortality from causes considered amenable to health care;

2. Mortality from causes considered amenable to health care (exc. Ischaemic heart disease);

3. Mortality from causes other than those considered amenable to health care. • The ‘Vital Sign’ incorporates all three variants. The accompanying technical

documentation states: “The difference between amenable and non-amenable causes in their trends over time may provide evidence of the increasing (or decreasing) effectiveness of health care.”

Return to Table 1

Indicator(s)

35.

Deaths attributable to smoking

Domain Sub-domain Sub-sub-domain

Burden of ill-health Misc Due to smoking Sources

Description Detail

Available

from

Estimated directly age standardised rate, age 35+

LA level, 2003-05 (or latest available)

Latest APHO Health Profiles at

www.communityhealthprofiles.info.uk

Comments

• Anybody wishing to attempt this complex calculation at a lower level should consult the documentation from ERPHO at

http://www.communityhealthprofiles.info/indicators/19SmokingAttributableMortalityIndi cator.php.

(32)

Indicator(s)

36.

Diabetes – modelled v. recorded prevalence

Domain Sub-domain Sub-sub-domain

Burden of ill-health Diabetes General Sources

Description Detail

Available

from

PBS Model Phase 3

Ward level and above, estimates 2005

QOF data

Go to

Projections

PBS Model Phase 3

Ward level and above, forecasts to 2025

http://www.yhpho.org.uk/PBS_diabetes.aspx #1

Comments

• The PBS model estimates diagnosed and undiagnosed prevalence. It is due to be extended to provide practice-level estimates. Estimates are available broken down by gender, broad age-group, and ethnic group.

Return to Table 1

Indicator(s)

37.

Estimated excess deaths among people with diabetes

Domain Sub-domain Sub-sub-domain

Burden of ill-health Diabetes General Sources

Description Detail

Available

from

Estimated % of deaths aged 20-79 attributable to diabetes

PCT level, 2005

http://www.yhpho.org.uk/resource/item.aspx? RID=9909

Comments

http://www.yhpho.org.uk/default.aspx? RID=8467

(33)

Indicator(s)

38.

Coronary heart disease (CHD) mortality

Domain Sub-domain Sub-sub-domain

Burden of ill-health Circulatory Coronary Heart Disease Sources

Description Detail

Available

from

Death numbers, rates and ratios

LA and PCT level, up to 2004-06

www.nchod.nhs.uk. Look for ‘Mortality from coronary heart disease’.

Comments

• An appropriate measure would be the Directly Age Standardised Rate < 75. • NHS organisations may be able to calculate for lower geographical levels.

Indicator(s)

39.

Coronary heart disease (CHD) – modelled v. recorded prevalence

Domain Sub-domain Sub-sub-domain

Burden of ill-health Circulatory Coronary Heart Disease Sources

Description Detail

Available

from

Modelled CHD prevalence

PCTs, 2006

www.apho.org.uk/apho/models.aspx provides links to APHO CHD model

methodology and results. Click on ‘Modelled data for 2007/08 LDPs’ for summary results, or ‘CHD Model and Benchmarking Tool’ (under ‘Tools’) for more detail.

QOF data

Go to

Comments

• Purpose of APHO CHD model was to validate QOF registers. There may be cases of CHD which have been diagnosed but not entered on register.

• The model relies upon people giving reliable answers to a question in the Health Survey for England asking whether they had been diagnosed with CHD.

• POPPI (www.poppi.org.uk) contains a projection of the number of older people with a long-term health condition caused by a heart attack. This is not measuring the same thing, but may be thought relevant.

(34)

Indicator(s)

40.

Hospital admission rate for MI (proxy for incidence)

Domain Sub-domain Sub-sub-domain

Burden of ill-health Circulatory Coronary heart disease Sources

Description Detail

Available

from

Number and Directly Age Standardised Rate

LA (PCT

forthcoming)

http://www.apho.org.uk/default.aspx? QN=P_HES

Comments

Indicator(s)

41.

Admissions for cardiac revascularisation

Domain Sub-domain Sub-sub-domain

Burden of ill-health Circulatory Coronary heart disease Sources

Description Detail

Available

from

LA (PCT

forthcoming)

Go to www.yhpho.org.uk

Choose ‘Revascularisation, main operations’. Indicator will also be added to PCT Maps as soon as possible.

Comments

Indicator(s)

42.

Stroke mortality

Domain Sub-domain Sub-sub-domain

Burden of ill-health Circulatory Stroke Sources

Description Detail

Available

from

www.nchod.nhs.uk. Look for ‘Mortality from stroke’.

Comments

(35)

Indicator(s)

43.

Hospital admission rate for stroke (proxy for incidence)

Domain Sub-domain Sub-sub-domain

Burden of ill-health Circulatory Stroke Sources

Description Detail

Available

from

LA and PCT

Comments

• POPPI (www.poppi.org.uk) contains a projection of the number of older people with a long-term health condition caused by a stroke. This is not measuring the same thing, but may be thought relevant.

Indicator(s)

44.

Cancer registrations

Domain Sub-domain Sub-sub-domain

Burden of ill-health Cancer By site Sources

Description Detail

Available

from

Incidence rates

www.nchod.nhs.uk. Look for ‘Incidence of’ various types of cancer.

Cancer E-Atlas (Northern, Yorkshire & Humber and East Midlands only)

LA http://www.apho.org.uk/resource/view.aspx? RID=47601

Comments

• Types of cancer for which three-year counts are sufficiently large to be disclosed on the non-NHS version of NCHOD are:

o All cancers

o All skin cancers

o Breast cancer

o Colorectal cancer

o Lung cancer

o Prostate cancer

Return to Table 1 http://www.apho.org.uk/default.aspx?

(36)

Return to Table 1

Indicator(s)

45.

COPD mortality

Domain Sub-domain Sub-sub-domain

Burden of ill-health Respiratory COPD Sources

Description Detail

Available

from

www.nchod.nhs.uk. Look for ‘Mortality from bronchitis, emphysema and other chronic obstructive pulmonary disease’.

Comments

• An appropriate measure would be the Directly Age Standardised Rate < 75.

Indicator(s)

46.

COPD – modelled v. recorded prevalence

Domain Sub-domain Sub-sub-domain

Burden of ill-health Respiratory COPD Sources

Description Detail

Available

from

LAs, 2008

APHO website

(http://www.apho.org.uk/resource/browse.as px?RID=48313). Click on link for Local authority estimates of COPD prevalence and COPD prevalence model. Results are in ‘Results-LA’ sheet (scroll along to find it). Modelled

COPD prevalence

PCTs, 2008

APHO website

(www.apho.org.uk/resource/browse.aspx?RI D=48313). Click on link for Model based prevalence of COPD at PCT level (updated Feb 2008). Results are in first sheet.

QOF data

Go to

Comments

• For an article comparing the APHO prevalence model with QOF, see

www.hsj.co.uk/insideknowledge/2008/03/qof_medicine__improving_the_detection_of _copd.html

• POPPI (www.poppi.org.uk) contains a projection of the number of older people with a long-term health condition caused by bronchitis and emphysema. This is not

(37)

Indicator(s)

47.

TB notifications

Domain Sub-domain Sub-sub-domain

Burden of ill-health Infectious TB Sources

Description Detail

Available

from

Notification rates and numbers

SHA level and above, 2006

www.nchod.nhs.uk. Look for ‘Incidence of tuberculosis’.

Rate bands PCT, up to 2005

http://www.hpa.org.uk/web/HPAweb&HPAwe bStandard/HPAweb_C/1195733750930

Crude rate

LAs, 2004-2006 average

2008 APHO Health Profiles, due this summer on www.communityhealthprofiles.info

Comments

Indicator(s)

48.

KC60 GUM STI data, particularly gonorrhoea

Domain Sub-domain Sub-sub-domain

Burden of ill-health Infectious STIs and HIV Sources

Description Detail

Available

from

New episodes and

diagnoses at GUM clinics

Various tables at SHA level

http://www.hpa.org.uk/web/HPAweb&HPAwe bStandard/HPAweb_C/1195733775264#data

Comments

• Further STI data can be requested by completing the form at

http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1210231688758 and returning it to the named contacts. The level of detail that can be provided will be limited due to disclosure control. See also following point about difficulty in calculating rates.

• NB – Rates are currently calculated by taking diagnoses or episodes at GUM clinics in the SHA, and dividing by that SHA’s resident population. This method may be

acceptable at the regional level, but not LA or PCT level, as not all have their own GUM clinic. The HPA are developing resident-based prevalence rates for local authorities, which should be available by the end of 2008.

(38)