1. www.lho.org.uk Ethnic Monitoring: Improving Service Delivery? Dr Bobbie Jacobson Monitoring health and health care in the capital, supporting practitioners and informing decision-makers

2. The role of the PHOs To monitor health and its determinants; To highlight future health problems; To assess the health impact of potential and past policies and To work in partnership with regional and local health policymakers, practitioners and those interested in health actions.

3. PHO Lead, National Roles Lead Policy Areas EMPHO Teenage Pregnancy ERPHO Primary Care, Methodologies LHOHealth Inequalities, Social Exclusion & Regeneration NEPHOMental Health, Prison Health, Children & Young People NWPHO Drug Misuse, Health Protection SEPHOCHD & Stroke SWPHO Accidents & Injury, Sexual Health WMPHO Cancers, Older People, Environment YHPHO Diabetes

4. Aims of the London Health Observatory

5. ETHNIC DISPARITIES IN HEALTH AND HEALTH CARE CHD: South Asians moderately higher rates than other groups Cancer: little systematic research, no reliable routine data Diabetes: Much higher prevalence amongst South Asians, raised rate amongst Black Caribbeans Mental Health: Male suicide rates elevated for those born in Scotland and Ireland

6. Hospital Episode Statistics (HES) Every hospital episode in England and Wales Patient coded for e.g sex, age group, diagnosis, ethnicity Problems with ethnicity coding well known

7. London StHA ALL CANCER North West8293 North Central7181 North East69 South East6980 South West7082 Episodes Coded For Ethnicity (%)

8. North WestHAMMERSMITH8395 ST MARY'S8694 NORTH WEST LONDON7080 North CentralUNIVERSITY COLLEGE LONDON7284 NORTH MIDDLESEX9389 ROYAL FREE HAMPSTEAD6882 North EastBARTS AND THE LONDON7059 BARKING, HAVERING AND REDBRIDGE7177 WHIPPS CROSS6068 South EastQUEEN ELIZABETH HOSPITAL7987 GUY'S AND ST THOMAS'8587 BROMLEY5066 South WestTHE ROYAL MARSDEN94 ST GEORGE'S55 EPSOM AND ST HELIER8589 Ethnicity Coding Of Episodes, by Provider (%) ALL CANCER

9. Ethnicity Coding for Cancer Episodes By Age Group (%) StHA<1515-3031-4546-64>65 North West92889293 North Central9081838179 North East6863586772 South East6470828180 South West9378778182

10. Ethnicity Coding for Selected Cancer Sites (%) StHABladderBreastColonLungOvaryProstate North West94 9394 85 North Central798187808184 North East797675715977 South East908685778283 South West857783778380

11. Issues for interpreting Disparities Levelling up between worst and best Improving recording of registry data Integrating screening data Research and adjustments for need

12. Want more information on health in London? Visit: http://www.lho.org.ukhttp://www.lho.org.uk The London Health Observatory: monitoring health and health care in the capital, supporting practitioners and informing decision-makers