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Developing public health intelligence in Yorkshire & Humber region Professor Brian Ferguson, Director Yorkshire & Humber Public Health Observatory Public health intelligence • ‘what is going on’? – health surveillance – disease problems …… lifestyle factors and wider determinants – knowing the picture at a particular point in time (cross-sectional data) – knowing what is happening over time (trend or time series data) • defining what is possible from the available knowledge base • defining what is feasible – resources – time constraints – political realities • monitoring and evaluation – assessing impact – did it work / what did we learn? “Promoting and delivering public health intelligence” Comparing ourselves with mainland Europe • what are the regions of Europe? • who might we compare ourselves to in Yorkshire & Humber? • what sort of data / indicators already exist? “Promoting and delivering public health intelligence” The NUTS classification • Nomenclature of Units of Territorial Statistics (NUTS) • In the 25 EU countries there are 114 NUTS 1 level regions and 279 NUTS 2 level regions • Yorkshire & Humber is a NUTS 1 level region with 4 NUTS 2 sub-regions: – – – – East Riding & North Lincolnshire North Yorkshire South Yorkshire West Yorkshire “Promoting and delivering public health intelligence” Yorkshire & Humber region “Promoting and delivering public health intelligence” Suggested criteria for comparative regions • population size and density • economic output (per capita Gross Domestic Product, GDP) • life expectancy at birth “Promoting and delivering public health intelligence” Initial analysis: Yorkshire & Humber vs. Oost-Nederland Indicator Yorkshire & Humber Oost-Nederland Crude population (millions) 5.1 3.4 Population density (average persons per hectare) 324 349 24,535 23,279 Life expectancy at birth (women) 80.9 80.5 Life expectancy at birth (men) 76.3 75.4 Per capita GDP (Euros) “Promoting and delivering public health intelligence” Female life expectancy: Yorkshire & Humber region vs. EU regions 90 Years 85 Oost-Nederland 95 Yorkshire & Humber FEMALE LIFE EXPECTANCY AT BIRTH by European Health Region English Regions with 95% CI, 1999-01 80 EU15 EU25 75 70 65 Source: Eurostat, Cronos Database. “Promoting and delivering public health intelligence” Infant mortality: Yorkshire & Humber region vs. EU regions INFANT MORTALITY RATE, by WHO European Region English Regions with 95% CI, 1998-2000 average 14 Rate per 1,000 live Births 12 10 8 6 Europe 4 2 0 OostNederland Yorkshire & Humber Source: Eurostat “Promoting and delivering public health intelligence” Infant mortality: English regions INFANT MORTALITY by GOR Crude rate per 1,000 livebirths with 95% CI, 2002-04 Post-neonatal Neonatal 8 1.9 7 3.9 Yorkshire & Humber 2.9 1 East of England 2 2.8 3 England 4.9 1.8 3.8 North West 2.0 1.6 3.9 East Midlands 1.8 3.6 1.8 3.1 North East London 1.3 3.1 South West 1.4 4 1.4 5 South East Rate per 1,000 6 West Midlands 0 Source: NHCOD Compendium * LADs deaths & livebirths aggregated into quintiles of equal livebirth numbers “Promoting and delivering public health intelligence” All cause mortality 0-14 years: Yorkshire & Humber region vs. EU regions ALL CAUSE MORTALITY by European Region Crude death rate with 95% CI, age 0-14 years, 1999-01 average 100 Crude rate per 100,000 80 60 EU25 EU15 40 Oost-Nederland 0 Source: WHO, ONS Vital Statistics & ONS population MYE Yorks & Humber 20 “Promoting and delivering public health intelligence” Transport accident mortality: Yorkshire & Humber region vs. EU regions TRANSPORT ACCIDENT MORTALITY by European Region Crude death rate with 95% CI, age 0-14 years, 2000-02 average 12 Rate per 100,000 10 8 6 4 EU15 EU25 Source: EUROSTAT Oost-Nederland 0 Yorks & Humber 2 “Promoting and delivering public health intelligence” Issues and questions for us to consider • making sensible comparisons between regions in health terms – but can these be the same comparators as we use for wider economic and social indicators? • adding context to the data / indicators – need to undertake and understand sub-regional analysis at NUTS 2&3 levels • do we know of other work to identify comparator regions to Yorkshire & Humber? “Promoting and delivering public health intelligence” Contact Details www.yhpho.org.uk Alcuin Research and Resource Centre The University of York Heslington YORK YO10 5DD United Kingdom Telephone: 01904 724583 Email: [email protected] “Promoting and delivering public health intelligence”