Selection of data items in the Health Survey for England (HSE)

Jennifer Mindell & Deanna Exeter

EHES training seminar 11th February 2010

Overview

• Overview of data collection

• Why they were selected

• Past history

• How they are now selected

• Core and additional moduleso Interview datao Nurse measurements

Survey method - Outline

• Two-stage sampling from Postcode Address File

• Advance letter

• Visit to the home by trained interviewer

• Visit to the home by trained nurse

Why are data items selected?(What is HSE used for? )

• To inform Government on where to allocate their resourceso Tobacco control campaignso To increase fruit and vegetable consumption

• To provide valuable information to help make people’s lives healthier, and encourage them to make healthier choices

• To set out and monitor key health objectiveso Obesity, CVD, respiratory disease

HSE special topics

• Cardiovascular disease 1991-1994, 1998, 2003, 2006

• Respiratory disease, accidents & disability 1995, 1996, 2001, 2002, 2010

• Physical activity 1997, 1998, 2003, 2006, 2008

• Young people 1997, 2002

• Older people 2000, 2005

• Minority ethnic groups 1999, 2004

• Knowledge and attitudes 2007

• Kidney disease 2009

How modules & data items are selected now1. Funding

• 1991 – 2004o HSE funded by Department of Health (DH)

• 2005 - 2009o HSE funded by NHS Information Centre (IC)

• HSE 2010 and HSCS 2011 onwardso Core funded by ICo Additional modules / Boost groups funded by

relevant groups in DH

How modules & data items are selected now2. Core item selection HSE 2010 and HSCS 2011+

• Consultation process before HSCS tenderedo Ascertain necessity and content for HSCS from stakeholders

and data users

• Discussions between IC and Joint Health Surveys Unit (NatCen + UCL)o Proposals costed by NatCen

• Discussions by HSCS Steering Group• Balance between ‘wish list’ and costs

o Increased length of core interview from 30’ to 50’ (concurrent interview with two people)

o Reduced content of core nurse visit

Core content Stage 1: Interviewer visit• Household questionnaire

• Individual interviewo Precise content under discussion with Steering group

• Height & weight (measured)

Interview visit: New from 2010

• New from 2010o Self-care plans

• New from HSCS 2011o Social care

Proposed core content Stage 2: Nurse visit

• Questionnaire• Measurements

o Eg Blood pressure• Samples

How modules & data items are selected now3. Additional modules HSE 2010 and HSCS 2011+

• JHSU run workshops for DH staff• Discussions between IC & DH and IC & JHSU

o Proposals costed by NatCen

• Discussions by HSCS Steering Groupo Major focus for next five years

• Balance between ‘wish list’, costs, and durationo Limited options for additional interview questionso Self-completions in nurse visito Additional analytes from blood samples

How were recent new modules selected?1. Physical activity HSE 2008

• Increasing levels of obesity • Population leading increasingly inactive lifestyles • Physical activity only an intermittent module (too time-

consuming)• Revised questionnaire for adults and children (longer!)

o Increased accuracy of estimateso Bring questionnaire in line with new government guidelines

• Objective measuremento Actigraph TM1

• Objective measurement of fitnesso Step test

The step test:Indicator of health risk independent of obesity

• Measure of functional aerobic work capacity (Vo2max)

• Stepping exercise to a set rhythm, getting faster

• Heart rate recorded while stepping and afterwards• Validation study

o Practicality (eg size of step)o Validity of data

How were recent new modules selected?2. Respiratory disease and function HSE 2010

• Why chosen?o New DH standards on identifying and treating chronic

respiratory disease due 2010o Need baseline data then monitoring progress

• How chosen?o Proposed by JHSUo Funded by DH

• How measured?o Revised questionnaire (previously conducted in 2001)o Objective measurement of lung function

How were recent new modules selected?2. Lung function measurement HSE 2010

• Research by JHSUo Costo Practicalitieso Supporto Data quality

• Decision from DH on equipment• Dress Rehearsal September 2009

o Feedback from nurseso Review data collectedo Amend training

• Launched January 2010

HSE reports

• Current trend tables: www.ic.nhs.uk/pubs/hse08trends

HSE 2004 - 2008 reports• www.ic.nhs.uk/statistics-and-data-collections/health-and

-lifestyles-related-surveys/health-survey-for-england

• www.ic.nhs.uk/pubs/hse08physicalactivity • www.ic.nhs.uk/pubs/hse07healthylifestyles

• Reports up to 2003: www.dh.gov.uk/PublicationsAndStatistics/PublishedSurvey/HealthSurveyForEngland/fs/en

Further HSE information:

• HSEo www.natcen.ac.uk/series/health-survey-for-england o www.ucl.ac.uk/hssrg/hse.html o www.esds.ac.uk/government/hse

• Archived datao www.data-archive.ac.uk/findingData/hseTitles.asp