Introducing the LHO Dr Bobbie Jacobson Director

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Introducing the LHO Dr Bobbie
JacobsonDirector
www.lho.org.uk
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APHO The Observatory Network and Lead Areas
LHO lead areas Health inequalities Ethnicity Smok
ing NICE
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LHO What do we do?

• We work in partnership to turn health data into
  intelligence to support decision-making on
  commissioning health and health care
• We monitor, forecast and assess the impacts of
  health policy in London
• We are a hub for signposting health intelligence
  and develop innovative methods for
  sharing/managing that knowledge.
• We work with APHO and researchers to produce
  national e-tools, reports and advice to support
  local action
• We help build analytic capacity in Londons
  workforce

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Role of PHOs in health intelligence
Collecting Data/ Information
Collating/ Processing Data
Using Health Intelligence To Improve Health
Care
Turning Data into Health Intelligence
Other Agencies
Public Health Observatory role
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Differences in Life Expectancy within a small
area in London
Travelling east from Westminster, each tube stop
represents nearly one year of life expectancy
lost
Male Life Expectancy 77.7 (CI 75.6-79.7) Female
Life Expectancy 84.2 (CI 81.7-86.6)
Male Life Expectancy 71.6 (CI 69.9-73.3) Female
Life Expectancy 80.6 (CI 78.7-82.5)
Canning Town
Westminster
Canary Wharf
London Bridge
River Thames
Canada Water
North Greenwich
Bermondsey
Waterloo
Southwark
Electoral wards just a few miles apart
geographically have life expectancy spans varying
by years. For instance, there are eight stops
between Westminster and Canning Town on the
Jubilee Line so as one travels east, each stop,
on average, marks nearly a year of shortened
lifespan. 1
London Underground
Jubilee Line
1 Source Analysis by London Health Observatory
using Office for National Statistics data.
Diagram produced by Department of Health
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What Range of work does LHO do?
Tools and methods
One stop Query desk/free web access to
intelligence
Inequalities Intervention tool Practice
profiles Basket of Indicators
Supporting Health Practitioners

Comparative
analysis/interpretation
-Monitoring Public health Performance -community
health profiles -Commissioning for Equity Series


Public Health Advocacy
RESPONSIVE
PRO-ACTIVE
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The LHO rolling business plan 2008/9

• Core programme
• Strategic health intelligence projects to support
  local decision-making in London
• Responsive enquiry service
• Health intelligence support to APHO National
  Programmes
• Externally commissioned programme
• Bespoke health intelligence projects commissioned
  directly from LHO by local and national agencies

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Examples of Recent LHO Work

• Local authority health Profiles 2008
• The Health Inequalities Intervention Tool
• World Class Healthcare in London Briefings
  (Stroke and Mind the Gap!)

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Local authority Health profiles 2008

• 32 indicators profiling comparative health in 386
  English local authorities
• Produced by APHO annually for DH
• Easily accessible via an interactive webtool
  www.healthprofiles.info
• Information on trends, health inequalities,
  benchmarking at LA level and below.

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Barking and Dagenhams Health Profile
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Barking and Dagenhams Health Profile
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(No Transcript)
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What is the Health Inequalities intervention tool?

• Planning tool to help PCTs and LAs with local
  delivery planning and commissioning to reduce
  inequalities in life expectancy
• Commissioned by Department of Health and produced
  by LHO and YHPHO for APHO

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What does the tool do?

• Quantifies the current life expectancy gap at
  birth within local authority areas, and between
  spearhead local authorities and England
• Quantifies the diseases contributing to the life
  expectancy gap
• Model the effect of four high impact
  interventions on closing the life expectancy gap

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Why use the tool?

• There are inequalities in life expectancy within
  all local areas spearhead and non-spearhead
• Examples of life expectancy gap between Most
  Deprived Quintile and Local Authority as a whole
  in London
• Bromley (non-spearhead) 4 year difference, 5
  gap (males)
• Lewisham (spearhead) 3 year difference, 4.5
  gap (males)

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Understanding the gap

• Variation in the main diseases which make up the
  within LA gap across the country
• Key diseases making up the gap in males in two
  egs (Most Deprived Quintile compared to Least
  Deprived Quintile)

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If females in the most deprived quintile had the
same mortality rate from stroke as females in the
least deprived quintile, they would live 0.5
years longer
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Applying evidence- based measures to show impact
on the gap

• Interventions included
• Increasing smoking quitters
• Improving blood pressure control in people
  without diagnosed CVD
• Improving blood cholesterol control in people
  without diagnosed CVD
• Reducing infant mortality
• Modelling of two scenarios
• Applying the interventions across the LA as a
  whole
• Focusing the interventions in the MDQ(Most
  Deprived Quintile)

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Applying the interventions in the Most Deprived
Qunitile(MDQ)

• Chart shows the reduction in the within area life
  expectancy gap in males in Lewisham if the
  following interventions are applied

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Want to know more?

• www.lho.org.uk
• Local health profiles www.healthprofiles.info
• Health inequalities intervention tool
  http//www.lho.org.uk/HEALTH_INEQUALITIES/Health_I
  nequalities_Tool.aspx