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Northern Ireland Context - RPA
EHSSB NHSSB SHSSB WHSSB
Regional Public Health Agency
Regional Health and Social Care Board
Business Support Organisation
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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
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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
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Agency is Health Intelligence Driven
• Institute of Public Health• Centre of Excellence
• INIPHO• NISRA
• DHSSPSNI• Universities
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What do we need to know?
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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
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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
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Smoking
•Lung cancer•Cardiovascular disease•Primary Care Registers(QOF)
Disease burden
•Specialist smoking cessation services
PreventionPrevalence
•Adults•Manual workers•Young people
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Help!
Pinpointing target populations in order to maximise resources and interventions
Application of regional survey data;Confidentiality;Statistical significance;Data quality;Data protection
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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)
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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
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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.