Northern Ireland Context - RPA

EHSSB NHSSB SHSSB WHSSB

Regional Public Health Agency

Regional Health and Social Care Board

Business Support Organisation

Regional Public Health Agency

• New centre of public health expertise

• Focus on improving and protecting health and wellbeing

• Work in partnership with stakeholders, especially local government, to get right into the heart of communities to improve life chances for all

N Ireland Public Health Agenda

• Life Expectancy – increase average life expectancy & decrease differential between most disadvantaged areas and NI average

• Smoking – reduce proportion of adults/manual workers who smoke• Obesity – halt rise in obesity

• Alcohol & Drug Misuse – reduce adult binge drinking & young people drinking and getting drunk & reduce young adults taking

illegal drugs & reduce children at risk from parental dependency on alcohol/drug taking

• Suicide – reduce suicide rate• Births to Teenage Mothers – reduce birth rate to mothers under 17

• Health screening – bowel/abdominal aortic aneurysm/foetal abnormalities

Public Service Agreement Priorities for Action

Agency is Health Intelligence Driven

• Institute of Public Health• Centre of Excellence

• INIPHO• NISRA

• DHSSPSNI• Universities

What do we need to know?

Evidence on Health Inequalities

• Differences in mortality exist by social group and by area

• Social and area differences are closely connected

• Significant relationship between place, health and socio-economic status

Emphasis on prevention of ill health

• Care and resources need to be deployed more discerningly by targeting very specific population groups

• Providing blanket solutions neither makes financial sense nor does it tackle inequalities

• Need to identify the smallest pockets of deprivation and inequalities

Smoking

•Lung cancer•Cardiovascular disease•Primary Care Registers(QOF)

Disease burden

•Specialist smoking cessation services

PreventionPrevalence

•Adults•Manual workers•Young people

Help!

Pinpointing target populations in order to maximise resources and interventions

Application of regional survey data;Confidentiality;Statistical significance;Data quality;Data protection

Prevalence Data Sources• Health and Social Wellbeing Survey (%age of

adults who reported they currently smoke/have given up smoking/never smoked)

• N Ireland Continuous Household Survey (attitudes to smoking, smoking status, history of quitting)

• Young People’s Behaviour and Attitudes Survey (%age of teenagers who reported they currently smoke/have ever smoked)

• Infant Feeding Survey (%age reporting smoking status before, during and after pregnancy)

Specialist Smoking Cessation Data Source

• Elite Database (web base recording system) – only covers people using specialist smoking cessation services. Other individuals may use Brief Intervention which is not currently monitored. Does not include people who quit by themselves.

• DHSSPSNI Report

Disease Burden Data Sources

• Deaths by cause• Hospital admissions by cause• Cancer incidence• Quality & Outcomes Framework (QOF) –

payment system to GPs for providing good care. QOF registers for clinical areas include coronary heart disease, hypertension, stroke.