Health Inequalities in Wessex Angela Baker, PHE South East Slides produced by Jo Wall, Public Health England South East LKIS

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IMD Map produced in Local Health

IMD and mortality rate from causes considered preventable Clear association between the two variables – LAs with higher levels of deprivation have higher rates of mortality from causes considered preventable From PHOF, Fingertips

Mortality rate from causes considered preventable The basic concept of preventable mortality is that deaths are considered preventable if, in the light of the understanding of the determinants of health at the time of death, all or most deaths from the underlying cause (subject to age limits if appropriate) could potentially be avoided by public health interventions in the broadest sense.

Inequality in life expectancy at birth Even the least deprived LAs have inequalities Taken from PHOF, Fingertips. This indicator measures inequalities in life expectancy within English local authorities using the Slope Index of Inequality (SII). The SII is a measure of the social gradient in life expectancy, i.e. how much life expectancy varies with deprivation. It takes account of health inequalities across the whole range of deprivation within each local authority and summarises this in a single number. This represents the range in years of life expectancy across the social gradient from most to least deprived, based on a statistical analysis of the relationship between life expectancy and deprivation across all deprivation deciles. Social gradient in life expectancy is lower for females but still present

Inequality in healthy life expectancy at birth Greater inequalities for healthy life expectancy Taken from PHOF, Fingertips. The same idea here but for healthy life expectancy. Healthy life expectancy is a measure of the average number of years a person would expect to live in good health based on contemporary mortality rates and prevalence of self-reported good health. The prevalence of good health is derived from responses to a question on general health in the 2011 Census. Greater inequalities for healthy life expectancy

School readiness – free school meals Children eligible for free school meals have significantly lower levels of development across all LAs in Wessex Children eligible for free school meals have significantly lower levels of development across all LAs in Wessex.

Inequalities in employment People with a long term condition or with a learning disability have lower employment rates. There is variation across Wessex. Taken from PHOF, Fingertips.

Inequalities in employment Taken from PHOF, Fingertips. People in contact with secondary mental health services have lower employment rates. There is variation across Wessex.

Smoking prevalence by socioeconomic group Taken from PHOF, Fingertips. Smoking prevalence is typically higher in the routine and manual occupations group Values are benchmarked against the average for the LA

Odds of smoking in routine and manual occupations The value presented is an odds ratio, representing the likelihood of those working in routine and manual occupations being current smokers compared with those working in professional or intermediate occupations. For Wessex LAs, all values are higher than 1 signifying that the routine and manual group are more likely to smoke than their counterparts. For Portsmouth, they are nearly 3 times as likely to smoke. Taken from PHOF, Fingertips. The value presented is an odds ratio, representing the likelihood of those working in routine and manual occupations being current smokers compared with those working in professional or intermediate occupations in any given geographical area. An odds ratio of 1 represents no difference between smoking prevalence rates in routine and manual occupations and other occupations. If the confidence intervals overlap 1, we are able to say with 95% confidence that there is no significant difference in smoking prevalence between the groups.  An odds ratio higher than 1 signifies the routine and manual group are more likely to smoke than their counterparts, for example if the odds ratio is 2, they have twice the odds of smoking. On the other hand, an odds ratio between 0 and 1 signifies that they are less likely to smoke, for example if the odds ratio is 0.5 they have half the odds of smoking. These data have not been age-standardised and, therefore, variation between area values may be a result of differences in population structure.   The numerator and denominator counts (which have been weighted to improve representativeness) are based on a sample of the population and, as such, represent estimates of the population values. Small sample sizes may cause fluctuations for smaller geographical areas, which should be interpreted with caution.

Smoking prevalence in adults with SMI 18.4 17.3 22.0 22.2 19.1 16.3 16.2 15.7 17.4 16.9 14.6 Taken from Fingertips: Mental Health and Wellbeing JSNA (Quality and Outcomes domain). Figures in the animated red box represent the QOF smoking prevalence for the general practice population for 2014/15. Please note that the two sets of figures are not directly comparable; the SMI population indicator only includes patients aged 18+ whereas the overall GP practice smoking prevalence includes individuals aged 15+. QOF smoking prevalence for GP practice population Smoking prevalence is much higher in adults with a serious mental illness

Inequalities slide sets We have developed standardised slide sets to demonstrate health inequalities at a local level (LA and STP) and deliver real changes in local conversations. The slides sets: Use data from PHE’s Local Health tool (www.localhealth.org.uk) to demonstrate ward level variation for Global Burden of Disease (GBD) regional priorities and other outcomes locally associated with income deprivation Act as easy-read briefings for public health professionals to present to lay audiences, including infographics, charts and maps Are currently available at upper tier LA and STP level The LA packs will be updated when 2017 GBD LA level data is published The following 2 slides are from the Hampshire and Isle of Wight (HIOW) STP pack and provide examples of the visualisations used. The indicator is hospital stays for self-harm; the indicator with the highest association with income deprivation at a ward level for HIOW. Slide sets are available here Inequalities briefings available on our SEPHIG KHub group. You will need to become a member of KHub and then request to join our group.

Hospital stays for self harm (2011/12-2015/16)

Hospital stays for self harm (2011/12-2015/16)

Angela Baker, Deputy Director, Health and Wellbeing Thank You Angela Baker, Deputy Director, Health and Wellbeing Jo Wall, Knowledge Transfer Facilitator For data queries please contact: jo.wall@phe.gov.uk 07909 533573