Day 1 Session 3 Measuring Some of the Big Issues in Public Health

1
Day 1 Session 3 Measuring Some of the Big
Issues in Public Health

• Cathy Mulhall
• South East Public Health Observatory
• Nov 2009

2
Learning objectives

• By the end of this session, participants should
  understand the insights health intelligence can
  offer
• along the disease course from determinants of
  health to health outcomes
• in investigating person, place and time
• in gaining a picture of key health issues

3
Overview

• Health intelligence within the bigger picture
• Prevention
• Demographics
• Incidence and prevalence
• Health outcomes
• Determinants of health

4
Health intelligence within the bigger picture
Life course
Infancy Childhood
Adult Young ? Old
Adolescence
Before Birth
Disease risk
TIME
5
Health intelligence within the bigger picture
Disease course
Recovery
Death
Disease risk
TIME
6
Health intelligence within the bigger picture

•  

Source Dahlgren and Whitehead (1991)
7
Health intelligence within the bigger picture
Source Hill, Griffiths, Gillam.
8
Prevention

• Primary prevent disease becoming established
• Secondary aims to detect early disease, slow
  down disease and prevent recurrence
• Tertiary aims to reduce the complications or
  severity, once disease is established

9
NHS Stop Smoking Services People setting a quit
date and successful quitters at 4 week follow up
Prevention Primary
Source The NHS Information Centre
10
Cervical screening coverage in women aged 25-64
Prevention Secondary
Source KC53 returns, The NHS Information Centre
11
Crude rates of revascularistaion and angiography
in a local PCT
Prevention Tertiary
Source Hospital admissions data
12
Demographics

• Population births, deaths, migration
• Projections
• Age, sex, ethnicity, socio- economic group
• Underpins most public health work
• Need to understand our population

13
Demographics
http//www.census.gov/ipc/www/idb/informationGatew
ay.php
14
Demographics
http//www.census.gov/ipc/www/idb/informationGatew
ay.php
15
Disease frequency - Incidence and Prevalence

• Incidence occurrence of new cases
• Prevalence frequency of existing cases

16
Incidence
Breast cancer incidence rate per 100,000 in South
Central SHA 1999 - 2003
Source Oxford Cancer Intelligence Unit
17
Rates of chlamydia diagnoses by age group
Incidence
Males
Females
Source Routine GUM clinic returns
18
Prevalence
Adult (aged 16 ) obesity prevalence
Source Organisation for Economic Co-operation
and Development (2005)
19
Prevalence of diabetes by sex, adults aged 16 and
over, 1991 to 2006, England (self-reported data)
Prevalence
Source Health Survey for England
20
Health outcomes

• disease (morbidity)
• recovery (survival)
• usage of health service
• death  (mortality)

21
Health outcomesMortality
Age-standardised mortality rate for European
regions, 2004-06
Source Eurostat
22
Health outcomesMortality
Top ten causes of death in males, all ages, 2003
Source Office for National Statistics
23
Health outcomesMortality
Top ten causes of death in females, all ages, 2003
Source Office for National Statistics
24
Determinants of health
Source Dahlgren and Whitehead (1991)
25
Determinants of health
Percentage of adults who smoke by sex Great
Britain 1974 to 2005
Source General Household Survey
26
Determinants of health
Percentage of adults eating 5 or more portions of
fruit and vegetables per day 2001 to 2007
Source Health Survey for England
27
Health Profiles
28
Summary

• By the end of this session, participants should
  understand the insights health intelligence can
  offer
• along the disease course from determinants of
  health to health outcomes
• in investigating person, place and time
• in gaining a picture of key health issues