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Estimating Small Area Health Indicators Using HSfE: Research Overview and Future Directions

This study gives an overview of deriving small area health indicators using synthetic estimation, addressing key issues like citizen-based public health, academic advancements, and determinants of health geographies. It includes data consolidation, known health risks, robust indicators, and linkage challenges at various spatial levels, proposing future extensions into other health domains. Conclusions highlight the utility of this approach in health profiling and methodological advantages.

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Estimating Small Area Health Indicators Using HSfE: Research Overview and Future Directions

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  1. Using the HSfE to estimate small area indicators of health need Graham Moon, Steve Barnard, Gemma Holt and Liz Twigg Institute for the Geography of Health, University of Portsmouth Bill Blyth TNS (Taylor Nelson Sofres)

  2. Aim • To provide an oversight of the outcomes of a programme of integrated projects focussed on the derivation of small area indicators of health need using synthetic estimation. • To outline key issues arising in this research

  3. Objectives • Citizen-based public heath • NSF drivers • Identifying the local geography of risk • Facilitating resource allocation and monitoring at a local scale • Flexible, consistent, bottom-up, robust (Wanless agenda) • Academic • Substantive advance in modelling methodology • Determinants of health geographies

  4. Data and Methods • Consolidated 1998-2003 • HSfE, • census • TNS data • + rest of UK) • Multilevel modelling

  5. The Indicators to Date I • Known Heart Disease • Known Heart Disease Risk • Undiagnosed Heart Disease Risk • Hypertension • Obesity + • Known Type II Diabetes • Undiagnosed Type II Diabetes NB population health measures not service users

  6. The Indicators to Date II • Flexible Organisational Geographies: • PCTs, • Wards, • General Practices • Other

  7. The Indicators to Date III Robust high quality indicators

  8. Linkage Issues • Question comparability • Changing geographies over time • The disappearance of DHAs • Geographical comparability of spatial levels • PSU = ward • Spatial identifiers • Not disclosed for general use

  9. Scale issues • Variation is scale dependent

  10. PCT Scale Diagnosed CHD Undiagnosed Risk of CHD

  11. Ward Scale Diagnosed CHD Undiagnosed Risk of CHD

  12. Scale GP Surgeries

  13. Alternatives • HES • QoF • IMD • Area typologies

  14. Alternatives - HES

  15. Alternatives QoF

  16. Alternatives –IMD

  17. Alternatives - Mosiac

  18. What next • Extend into other disease/health domains • Extend into non-health areas • Extend internationally • Link to health service inputs

  19. What next

  20. Conclusions • Healthy England • University environs • Army camps • New developments • Bristol • Unhealthy England • Tyne-Tees • Lincolnshire resorts • Black Country

  21. Conclusions • Major utility in health profiling • Clear advantages in methodological terms and through linkage with other sources

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