Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Public Health Key Data Sources

959 views

Published on

  • Be the first to comment

Public Health Key Data Sources

  1. 1. South West Public Health Observatory Key Data Sources for Public Health Public Health Information and Evidence Seminar Mark Dancox 4th November 2010
  2. 2. South West Public Health Observatory In this session • Main sources of data used in Public Health • Over-view of special methods used to measure the health of a population • Specific data sources for the South West
  3. 3. South West Public Health Observatory First things first • In public health we are often interested in the frequency, distribution and determinants of health problems and disease in populations. • The unit of interest is the POPULATION not the individual.
  4. 4. South West Public Health Observatory What data do we use? • Raw data, only available to NHS employees with appropriate role-based permissions: – Births – Deaths – Hospital Admissions – Cancer Registrations – GP consultations – Prescriptions – A&E attendances – Population • Need to aggregate data so that it can’t be identified
  5. 5. South West Public Health Observatory What’s the distribution? • Often want to tie in frequency information to location. • Consideration of geography is therefore important: – Postcode – Lower Super Output Area – Local Authorities – Primary Care Trusts – Strategic Health Authorities • Need to link geography information to births and deaths data • Social Marketing datasets linkage
  6. 6. South West Public Health Observatory • Mortality – All cause – Specific cause – Place of death • Life Expectancy – General measure of health – At birth – Disability Free • Births – Birth Rate – Infant Mortality Some common types of measures:
  7. 7. South West Public Health Observatory – Widely accepted system of classifying diseases and causes of death developed by the World Health Organisation. – Updated every 10 years or so to keep up with advances in medical knowledge and improvements in methods of diagnoses. – Changes in coding can present problems when looking at the occurrence of specific causes of death through time. – ONS regularly produce data on mortality statistics using the ICD-10 system. ICD-10
  8. 8. South West Public Health Observatory – Infectious and parasitic diseases – Neoplasms – Diseases of the blood and blood forming organs – Endocrinal and Nutritional diseases – Mental and behavioural disorders – Diseases of the circulatory system – Diseases of the respiratory system – Injury, poisoning and certain other causes of external consequences ICD-10 Headings include:
  9. 9. South West Public Health Observatory Hospital Admissions (HES) • Principal source of data on all admissions to NHS hospitals in England. • Data warehouse containing details of all admissions to NHS hospitals in England. • Includes private patients treated in NHS hospitals, patients who were resident outside of England and care delivered by treatment centres (including those in the independent sector) funded by the NHS. • Contains details of all NHS outpatient appointments in England
  10. 10. South West Public Health Observatory Determinants : Factors affecting health • Health is affected by many factors, as summarised by Dahlgren and Whitehead’s diagram…
  11. 11. South West Public Health Observatory What are the determinants ? • Age, sex and constitutional factors • Lifestyle • Agriculture and Food production • Education • Work Environment • Unemployment • Water and Sanitation • Health Care Services • Housing
  12. 12. South West Public Health Observatory Deprivation • Prepared by DCLG • Area based measure based on seven ‘domains’ – Health and Disability – Income – Employment – Education skills and Training – Barriers to housing and services – Crime – Living Environment • Applies to England • IMD2004 and IMD2007 available
  13. 13. South West Public Health Observatory Surveys • Established surveys can provide information on the determinants of health – Health Survey for England – General Household Survey – Longitudinal Study – Active People – National Child Measurement Program
  14. 14. South West Public Health Observatory Health Survey for England • Annual • Questionnaire-based answers with physical measurements and analysis of blood samples. • Blood pressure, height and weight, smoking, drinking and general health are covered every year. • An interview with each eligible person in the household is followed by a nurse visit.
  15. 15. South West Public Health Observatory General Household Survey • Information from people living in households in England • Annual • Data collected on – household and family information – housing tenure and household accommodation – consumer durables including vehicle ownership – employment – education – health and use of health services – smoking and drinking – family information including marriage, cohabitation and fertility – income – demographic information about household members including migration.
  16. 16. South West Public Health Observatory South West Observatory Modules • Further information on the determinants of health can be found via the modules of the South West Observatory: – Economy – Skills and Learning – Planning – Environment – Crime – Culture • State of the South West
  17. 17. South West Public Health Observatory Special methods of measuring public health • Published sources of Public Health data use different methods of measuring the health of a population: – Incidence – Prevalence – Crude Rate – Standardised Rates – (confidence intervals)
  18. 18. South West Public Health Observatory Prevalence Prevalence quantifies the proportion of individuals in a population who have the disease at a specific instant. Total number of cases at a given time Prevalence = Total population at that time Note: No time period is involved here.
  19. 19. South West Public Health Observatory Incidence Incidence quantifies the number of new cases of disease that develop in a population of individuals at risk during a specified time period. Number of new cases in period of time Incidence = Population at risk The denominator, “population at risk” , should consist of the entire population in which new cases can occur.
  20. 20. Incidence and prevalence Sick population (Prevalence) Healthy population Incidence (new cases) die (mortality) recover
  21. 21. South West Public Health Observatory Crude Rate • Is the number of cases in a population divided by the total population during a specific time interval. • Provides information on the experience of the population. • Useful for the allocation of health resources and public health planning. • However if comparing heart disease rates between two populations where one population had a larger proportion of young people then differences in rates might simply reflect the relationship between heart disease and age.
  22. 22. South West Public Health Observatory Category-Specific Rates • To account for different population distributions of a factor of interest we can present and compare category-specific rates. • These are calculated on a subgroup of the population which is defined by stratifying the populations into categories e.g age. • They permit comparisons between different categories within the same population.
  23. 23. South West Public Health Observatory Age standardisation • Occurrence of disease in one area may appear to be higher than in another because: – Population structures are different – One area is older than another • Standardisation used to adjust for the effects of age on mortality rates or other rates • Direct or Indirect • Involves the calculation of numbers of expected events which are then compared with numbers of observed events
  24. 24. South West Public Health Observatory Two Methods of standardisation • Different methods available but ‘Direct’ and ‘Indirect’ methods are most common • Can calculate confidence intervals for each • Which method used depends on the comparisons to be performed and the availability of data
  25. 25. South West Public Health Observatory When to use which? • No right or wrong approach, but… – Direct standardisation useful to compare different areas or through time – Indirect Standardisation useful to determine if disease incidence is high or low in one area.
  26. 26. South West Public Health Observatory Measures in action….Health Profiles
  27. 27. South West Public Health Observatory Measures in action….NCHOD
  28. 28. Thankyou Mark Dancox Mark.Dancox@swpho.nhs.uk

×