Health Impact Assessment Mental Wellbeing Local Health and

Health Impact Assessment & Mental Wellbeing Local Health and Wellbeing Indicators Lorraine Fahy Research Analyst Ireland Northern Ireland’s Population Health Observatory (INIs. PHO)

Health Impact Assessment & Mental Wellbeing Ø Introduction to INIs. PHO Ø Local health and wellbeing indicators o Use o Development o Examples

INIs. PHO • Established in 2005 • Housed in the Institute of Public Health (IPH) • An all-Ireland observatory • Supports each jurisdiction while maximising benefits of North/South working • Source of health intelligence/health information

INIs. PHO Better intelligence… Better decisions… Better health…

Some current work • • • Irish Health Poverty Index (i. HPI) All Ireland Health and Social Care Indicator Set (AIHSC) Injury Observatory for Britain and Ireland (IOBI) Health Analysts’ Special Interest Group e. Tools o INIs. PHO e. Data system o All-Ireland electronic Health Library (AIe. HL) • Event Series

Local health and wellbeing indicators

Factors affecting health & wellbeing Complex array of political, social, economic and environmental factors - and health and social services issues - that affect the health of a population Current health status as well as the future health status of an area

National data and local data Wide range of data available at national level on the broad determinants of health National figures can mask important differences at regional and local level Comprehensive data at local level on the broad determinants of health is needed to identify and address inequalities

Uses of local health indicators Guiding local and national action: • Putting the local situation into a broader context • Providing a national view of what’s going on at the local level Awareness raising – keeping health inequalities, their determinants and the needs of vulnerable populations on the agenda Specific applications facilitated by regional comparisons: • Local needs assessment & health impact assessment • Planning and delivery of health and social services • National co-ordination of local efforts • Monitoring broad progress on tackling health inequalities

INIs. PHO development of local health indicators No system for monitoring local health across the whole island Adapted two existing datasets to the whole island English Health Poverty Index (e. HPI) www. hpi. org Irish Health Poverty Index (i. HPI) Northern Ireland Health Inequalities Monitoring System www. dhsspsni. gov. uk/index/stats_research/stats-equality. htm All-Ireland Health and Social Care Indicator Set (AIHSC)

Collation of data Collated data on 82 indicators for 52 local regions across the island Local level: – 26 Local Government Districts in the North – 26 (traditional) counties in the South How comparable are measures from two different jurisdictions? Four categories of measures: – All-Ireland – North and South – North only – South only

i. HPI conceptual framework

A flavour of the information collected Health data: – Mortality and morbidity data – Life expectancy – Hospital admissions – Physical morbidity: benefits received for different types of physical conditions – Health and social services resourcing – Utilisation and access to health services

A flavour of the information collected Mental health data: – Living alone – Psychological morbidity – Suicide – Psychiatric admissions – Prescribing for anxiety and depression – Social support scale – Can people be trusted?

A flavour of the information collected Lifestyle data: – Physical activity – Smoking – Fruit and vegetable consumption – Alcohol abuse – Drug misuse Educational data: – Educational resourcing – Pupil to teacher ratio – Educational attainment

Web-based visualisation tool Tables, maps, spider plots and other charts An exploratory tool to look at: – Relationship between measures (at an area level) – Geographical variation in a single measure across the island – Profiles of a single area based on multiple-measures – Geographical comparisons based on multiple measures – Changes over time (when updated)

Accessing the datasets www. inispho. org/ihpi www. inispho. org/aihsc

Data briefings

A selection of Local Health and Wellbeing Indicators

Life expectancy – Northern Ireland vs Republic of Ireland Northern Ireland Highest male life expectancy Lowest male life expectancy Highest female life expectancy Lowest female life expectancy Republic of Ireland 78. 1 years 76. 9 years (Roscommon) (Ballymoney) 73. 5 years (Belfast) 72. 8 years (Leitrim) 82. 4 years 82. 2 years (Roscommon) (Ballymoney) 79. 3 years (Derry) 79. 3 years (Limerick)

Male life expectancy by LGD and county, 2002 -2004

Female life expectancy by LGD and county, 2002 -2004

Northern Ireland: Comparison of LGD with highest male life expectancy (Ballymoney) with LGD with lowest male life expectancy (Belfast)

Northern Ireland: Comparison of LGD with highest female life expectancy (Ballymoney) with LGD with lowest female life expectancy (Derry)

Comparing the most deprived LGD (Strabane) with the least deprived LGD (North Down)

Future Longer term interest in – an all-Ireland suite of local health and wellbeing indicators – a basis of local health and wellbeing profiles – links to comparative European data

Discussion