Health Impact Assessment & Mental Wellbeing

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

2. Health Impact Assessment & Mental Wellbeing • Introduction to INIsPHO • Local health and wellbeing indicators • Use • Development • Examples

3. INIsPHO • 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

4. INIsPHO • Better intelligence… • Better decisions… • Better health…

5. Some current work • Irish Health Poverty Index (iHPI) • All Ireland Health and Social Care Indicator Set (AIHSC) • Injury Observatory for Britain and Ireland (IOBI) • Health Analysts’ Special Interest Group • eTools • INIsPHO eData system • All-Ireland electronic Health Library (AIeHL) • Event Series

11. Local health and wellbeing indicators

12. 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

13. 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

14. 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

15. INIsPHO 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 (eHPI) • www.hpi.org • Irish Health Poverty Index (iHPI) • 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)

16. 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

17. iHPI conceptual framework

18. 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

19. 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?

20. 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

21. 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)

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

23. Data briefings

24. A selection of Local Health and Wellbeing Indicators

25. Life expectancy – Northern Ireland vs Republic of Ireland

26. Male life expectancy by LGD and county, 2002-2004

27. Female life expectancy by LGD and county, 2002-2004

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

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

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

31. 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

32. Discussion