1. Northern Ireland Context - RPA EHSSBNHSSBSHSSBWHSSBRegional Public Health Agency Regional Health and Social Care Board Business Support Organisation

2. Regional Public Health Agency New centre of public health expertise Focus on improving and protecting health and wellbeing Work in partnership with stakeholders, especially local government, to get right into the heart of communities to improve life chances for all

3. N Ireland Public Health Agenda Life Expectancy – increase average life expectancy & decrease differential between most disadvantaged areas and NI average Smoking – reduce proportion of adults/manual workers who smoke Obesity – halt rise in obesity Alcohol & Drug Misuse – reduce adult binge drinking & young people drinking and getting drunk & reduce young adults taking illegal drugs & reduce children at risk from parental dependency on alcohol/drug taking Suicide – reduce suicide rate Births to Teenage Mothers – reduce birth rate to mothers under 17 Health screening – bowel/abdominal aortic aneurysm/foetal abnormalities Public Service AgreementPriorities for Action

4. Agency is Health Intelligence Driven Institute of Public Health Centre of Excellence INIPHO NISRA DHSSPSNI Universities

5. What do we need to know?

6. Evidence on Health Inequalities Differences in mortality exist by social group and by area Social and area differences are closely connected Significant relationship between place, health and socio-economic status

7. Emphasis on prevention of ill health Care and resources need to be deployed more discerningly by targeting very specific population groups Providing blanket solutions neither makes financial sense nor does it tackle inequalities Need to identify the smallest pockets of deprivation and inequalities

8. Smoking Lung cancer Cardiovascular disease Primary Care Registers (QOF) Disease burden Specialist smoking cessation servicesSpecialist smoking cessation services PreventionPrevalence Adults Manual workers Young people

9. Help! Pinpointing target populations in order to maximise resources and interventions Application of regional survey data; Confidentiality; Statistical significance; Data quality; Data protection

10. Prevalence Data Sources Health and Social Wellbeing Survey (%age of adults who reported they currently smoke/have given up smoking/never smoked) N Ireland Continuous Household Survey (attitudes to smoking, smoking status, history of quitting) Young People’s Behaviour and Attitudes Survey (%age of teenagers who reported they currently smoke/have ever smoked) Infant Feeding Survey (%age reporting smoking status before, during and after pregnancy)

11. Specialist Smoking Cessation Data Source Elite Database (web base recording system) – only covers people using specialist smoking cessation services. Other individuals may use Brief Intervention which is not currently monitored. Does not include people who quit by themselves. DHSSPSNI Report

12. Disease Burden Data Sources Deaths by cause Hospital admissions by cause Cancer incidence Quality & Outcomes Framework (QOF) – payment system to GPs for providing good care. QOF registers for clinical areas include coronary heart disease, hypertension, stroke.