1. Iram Naz (Project Manager) Week 2: Looking at Health Deprivation Data

2. Learning outcomes: Week 2 Know more about what deprivation is and how it is measured Examine the link between ethnicity and health deprivation Be able to relay why health data so important in needs analysis Access health/area profile data available online Take part in a data task

3. What is deprivation? It is widely accepted that deprivation increases the risk of early death and is associated with higher rates of illness from certain diseases. For example, in relation to cardiovascular health, socioeconomic deprivation is associated with higher rates of admission to hospital and case fatality in heart failure.

4. How is deprivation measured Income Deprivation Employment Deprivation Health Deprivation and Disability Education, Skills and Training Deprivation Geographical Access to Services Crime Living Environment

5. Measuring Health There is no absolute measure of health. Commonly used measures include: – Mortality (deaths) – Morbidity Prevalence of disease/ Incidence – Disability (physical and mental) – Quality of life (via life style surveys etc)

6. –Many factors used to stratify society, e.g. –- Occupation –- level of education –- Employment Measuring Social Class I

7. Measuring Social Class Registrar General’s Scheme UK research uses primarily current or most recent occupation of the main earner to allocate families to a social class/ socio-economic group.

8. Causes for Class-based Health Inequalities The main explanations for health inequalities: –- Cultural/lifestyle explanation –- Materialist explanation

9. Cultural Explanation Differences in positive/negative behaviours of individuals in different social classes, e.g. poor people are more likely to smoke and/or drink, less likely to do exercise, etc.

10. Material Explanation I The poor more likely to be at risk from illness or accident and more removed from factors which positively promote health. Material deprivation can increase even when income increases, relative to structures and amenities.

11. Material Explanation II Individual behaviour is attributable to more than simply personal choice: Smoking can offer relief to the experiences of poverty, deprivation and the emotional pressures of child care. (Graham 1987)

12. Definition of Ethnicity “ An ethnic quality or affiliation resulting from cultural ties. Cultural, behavioural, linguistic, or religious practices.”

13. Ethnicity & Geography UK ethnic composition varies: majority in big cities; more geographically concentrated than whites, e.g. in West Midlands, 15% ethnic minority groups (with 9.7% South Asians). (ONS Projections)

14. Census question: Ethnicity Definition of ethnicity has problems

15. Ethnicity & Health Patterns in health and ethnicity are complex and contradictory, but: –Rates of diabetes over five times higher among Pakistani and Bangladeshi women than in the general population. –All male minority groups (except the Chinese) higher rates of heart attacks.

16. Ethnicity & Health Black Caribbean men higher rates of stroke. Mortality rates of common types cancer, such as breast and lung, are lower amongst Caribbeans and South Asians.

17. Ethnicity & Health Care Use Cultural and language barriers hinder communication between health professionals and clients, limiting health care provisions and its usage Different ethnic groups have different patterns of health service usage, e.g. – Chinese are persistent under–users of – health services, as are South Asian – Women.

18. Ethnicity and Social Class Ethnicity must be considered in relation to structural factors e.g: –- Poor housing –- Poverty –- Unemployment –- Social Exclusion

19. Multiple Deprivation Distinct dimensions of deprivation and disadvantage which can be identified and measured separately (Domains) People may be counted in one or more Domains depending on the number of types of deprivation they experience

20. The seven domains are: Income Deprivation (with sub-domains income deprivation affecting children and older persons) Employment Deprivation Health Deprivation & Disability Education, Skills & Training Deprivation Barriers to Housing & Services Crime & Disorder Living Environment

21. Where to access data on the main indicators of health deprivation? Mortality: (ONS) http://www.statistics.gov.uk/statbase/product.asp?vlnk=618 http://www.statistics.gov.uk/statbase/product.asp?vlnk=618 Morbidity: (ONS) http://www.statistics.gov.uk/cci/nscl.asp?id=6442 http://www.statistics.gov.uk/cci/nscl.asp?id=6442 Disability : (ONS) http://www.statistics.gov.uk/cci/nscl.asp?id=6345 http://www.statistics.gov.uk/cci/nscl.asp?id=6345 Quality of life Data: ONS http://www.statistics.gov.uk/cci/nscl.asp?id=8459

22. Why is data so important? Important for background material and setting the scene or placing current research in wider context Helps to identify need Identify gaps/Inequality Vast amount of existing data ‘out there’ Large amounts in government data banks

23. What data will be important for this research? Census data (ONS) overall health, demographic and population data Local Authority data (local data on wards and councils) Department for Health Data Sport England- (Active People’s Survey- participation levels in physical activity)

24. What data can I Access ONS Life Expectancy Data http://www.statistics.gov.uk/STATBASE/Product.asp?vlnk=10860 http://www.statistics.gov.uk/STATBASE/Product.asp?vlnk=10860 West Midlands Public Health Observatory (WMPHO) http://www.wmpho.org.uk/default.aspx http://www.wmpho.org.uk/default.aspx Active People’s Survey July 2009- July 2010 Sport England http://www.sportengland.org/research/active_people_survey/active_people_survey_4/aps4_quarter_3.aspx http://www.sportengland.org/research/active_people_survey/active_people_survey_4/aps4_quarter_3.aspx

25. Physical Activity Participation What is the recommended levels of participation in physical activity for adults? 30 minutes of moderate physical activity 3 times a week (3X30 minutes)

26. Data Task Use the data from the latest Active People Survey to answer the following questions: What change if any has there been in the participation levels 3X30 minutes of moderate physical activity in the following groups? non-white adults Adults overall in West Midlands Adults over the age of 55

27. Health Profile Data Using the Health Profile summary for your area identify 5 facts around the health of the population in that area?

28. The following websites are useful sources of, and gateways to, statistical and demographic information: –National Statistics www.statistics.gov.uk provides official UK statistics at both local and national levels. i.e. Census, Neighbourhood, UK snapshot, Economy data etcwww.statistics.gov.uk –www.ons.gov.ukwww.ons.gov.uk –Nomis (www.nomisweb.co.uk) is a source of official UK labour market statistics.www.nomisweb.co.uk –UK Data Archive (www.data-archive.ac.uk) is a resource centre for digital data in the social sciences and humanities.www.data-archive.ac.uk

29. Useful Sources of Information Acheson, D. 1998. Independent inquiry into inequalities in health report, The Stationery Office: London. Bartley, M., Blane, D., Davey Smith G. eds. 1998. The Sociology of Health Inequalities. Oxford: Blackwell Publishers, p.3 Frenk J, et al. 1993. ‘Elements for a theory of the health transition’. Chp 2 in: Chen LC, et al. eds. Health and social change in international perspective. Harvard Series on Population and International Health. Harvard UP: Boston. Townsend, P. & Davidson, N. 1982. Inequalities in health: the Black report,. Penguin: Harmondsworth. http://www.sochealth.co.uk/history/black6.htm.

30. Useful Sources of Information Klinenberg, E. 2002. Heat Wave: A Social Autopsy of Disaster in Chicago: University of Chicago Press. Marmot, M., & Wilkinson, R. G. eds. 1999. The Social Determinants of Health. Oxford: Oxford University Press Tudor Hart, J. 1971. ‘The Inverse Care Law’, The Lancet, I: 405 Wilkinson, R.G. 2004. Unhealthy societies. Routledge: London.

31. Any Questions?