1. Introducing the LHO Dr Bobbie Jacobson Director www.lho.org.uk

2. LHO lead areas: Health inequalities Ethnicity Smoking NICE APHO: The Observatory Network and Lead Areas

3. 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

4. Collating/ Processing Data Turning Data into Health Intelligence Collecting Data/ Information Using Health Intelligence To Improve Health & Care Other Agencies Public Health Observatory role Role of PHOs in health intelligence

5. Travelling east from Westminster, each tube stop represents nearly one year of life expectancy lost Westminster Waterloo Southwark London Bridge Bermondsey Canada Water Canary Wharf North Greenwich Canning Town London UndergroundJubilee Line Differences in Life Expectancy within a small area in London 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 River Thames 1 Source: Analysis by London Health Observatory using Office for National Statistics data. Diagram produced by Department of Health Male Life Expectancy 71.6 (CI 69.9-73.3) Female Life Expectancy 80.6 (CI 78.7-82.5) Male Life Expectancy 77.7 (CI 75.6-79.7) Female Life Expectancy 84.2 (CI 81.7-86.6)

6. What Range of work does LHO do? One stop Query desk/free web access to intelligence Tools and methods Supporting Health Practitioners Inequalities Intervention tool Practice profiles Basket of Indicators Comparative analysis/interpretation Public Health Advocacy RESPONSIVEPRO-ACTIVE -Monitoring Public health Performance -community health profiles -Commissioning for Equity Series

7. 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

8. 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!)

9. 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.infowww.healthprofiles.info Information on trends, health inequalities, benchmarking at LA level and below.

10. Barking and Dagenhams Health Profile

13. 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

14. 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

15. 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)

16. 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): Bromley (non- spearhead) Lewisham (spearhead) CHD (coronary heart disease)CHD Lung cancerStroke COPD (chronic obstructive pulmonary disease) Other CVD Other CVD (cardiovascular disease)Other cancers

17. 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

18. 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)

19. 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

20. Want to know more? www.lho.org.uk Local health profiles: www.healthprofiles.info www.healthprofiles.info Health inequalities intervention tool: http://www.lho.org.uk/HEALTH_INEQUALI TIES/Health_Inequalities_Tool.aspx http://www.lho.org.uk/HEALTH_INEQUALI TIES/Health_Inequalities_Tool.aspx