Health inequality target monitoring: update to include data for 2006

These reports summarise progress against Department of Health inequality targets for 2010 in the following areas: Infant mortality; life expectancy at birth for males and for females; cancer (premature mortality rate) and all circulatory diseases (premature mortality rate). Key facts Infant mortality The inequality gap in the infant mortality rate has reduced for the second consecutive period, though not yet by a sufficient amount to meet the target, based on the trend since the current socio economic classifications were introduced in 2001. Life expectancy at birth (males and females) The inequality gaps in male and female life expectancy at birth have both increased since the baseline. If current trends continue, the target would not be met. Cancer mortality The inequality gap in cancer mortality has declined since the baseline (despite a slight increase in the latest period), and the minimum requirement for the 2010 target has already been met. All circulatory diseases mortality The inequality gap in circulatory disease mortality has declined, and is on track to meet the target.

Health inequalities intervention tool: cost effectiveness of interventions

This note sets out the cost effectiveness performance of the interventions currently presented in the Health inequalities intervention tool . These interventions have been chosen for their cost effectiveness performance as health interventions as well as for their impact on the life expectancy gap.

Health inequalities intervention tool: technical document

This paper describes the data and methods used in the Health inequalities intervention tool to calculate the effect of four interventions on life expectancy.

Health inequalities intervention tool - presentation slides

The Spearhead Intervention Tool has been commissioned by the Department of Health through the Association of Public Health Observatories (APHO). This version of the tool has been updated with latest data for 2005-07. The tool is designed to assist commissioners in Spearhead Primary Care Trusts (PCTs) with their Local Delivery Planning (LDP) and commissioning and to assist Spearhead Local Authorities (LAs) with the delivery of Local Area Agreements (LAAs). It highlights key issues for Spearhead PCTs and LAs to consider in order to achieve the life expectancy element of the Government۪s Public Service Agreement (PSA) on health inequalities by 2010.

Tackling health inequalities: 2005-07 policy and data update for the 2010 national target

This document provides an update on progress to meet the health inequalities national target to reduce the gap as measured by infant mortality and life expectancy, by 10% by 2010. It includes an assessment of whether the 70 spearhead area local authorities, which map to 62 PCTs, are on track to meet the life expectancy target.

Health Inequalities Intervention Tool for Spearheads 2009 (Click SAVE NOT OPEN when prompted)

The Spearhead Intervention Tool has been commissioned by the Department of Health through the Association of Public Health Observatories (APHO). This version of the tool has been updated with latest data for 2005-07. The tool is designed to assist commissioners in Spearhead Primary Care Trusts (PCTs) with their Local Delivery Planning (LDP) and commissioning and to assist Spearhead Local Authorities (LAs) with the delivery of Local Area Agreements (LAAs). It highlights key issues for Spearhead PCTs and LAs to consider in order to achieve the life expectancy element of the Government̢?Ts Public Service Agreement (PSA) on health inequalities by 2010.

Health Inequalities Intervention Tool for Spearheads

The Spearhead Intervention Tool has been commissioned by the Department of Health through the Association of Public Health Observatories (APHO). This version of the tool has been updated with latest data for 2005-07. The tool is designed to assist commissioners in Spearhead Primary Care Trusts (PCTs) with their Local Delivery Planning (LDP) and commissioning and to assist Spearhead Local Authorities (LAs) with the delivery of Local Area Agreements (LAAs). It highlights key issues for Spearhead PCTs and LAs to consider in order to achieve the life expectancy element of the Government۪s Public Service Agreement (PSA) on health inequalities by 2010.

The London Health Inequalities Strategy - Draft for public consultation

This is the very first Health Inequality Strategy to be published for public consultation by the London Mayor. As such it represents a momentous step forward in galvanising action across London to address the health inequalities which prevent many Londoners from enjoying their life to the full and making the most of what London has to offer. The Greater London Authority Act 2007 requires that the strategy identifies the health inequalities, the priorities for reducing them and the role to be played by a defined list of key partners in order to implement the strategy. It defines health inequalities as inequalities in respect of life expectancy or general state of health which are wholly or partly a result of differences in respect of general health determinants۪, which it describes as: (a) standards of housing, transport services or public safety; (b) employment prospects, earning capacity and any other matters that affect levels of prosperity; (c) the degree of ease or difficulty with which persons have access to public services; (d) the use, or level of use, of tobacco, alcohol or other substances, and any other matters of personal behaviour or lifestyle, that are or may be harmful to health, and any other matters that are determinants of life expectancy or the state of health of persons generally, other than genetic or biological factors.

Health Inequalities Intervention Toolkit

This Health Inequalities Intervention Toolkit, developed jointly by the Association of Public Health Observatories and the Department of Health, focuses on improving life expectancy and infant mortality rates, especially in disadvantaged areas. Based on local authority boundaries, it is designed to assist evidence-based local service planning and commissioning, including Joint Strategic Needs Assessments. The Toolkit does this by providing information on the diseases, which are causing low life expectancy in individual areas, enabling good local priority setting. The Toolkit was originally designed to support achievement of the national Public Service Agreement target to: "Reduce health inequalities by 10% by 2010 as measured by infant mortality and life expectancy at birth." Although the PSA target has now ended, the Toolkit should still be useful to the NHS and local government, supporting planning to narrow inequalities in life expectancy and infant mortality

Mapping health inequalities across London

Analysis of infant mortality and life expectancy across London by various dimensions of inequality- socioeconomic; gender; geographical, and trends

Health Inequalities Intervention Tool (2011)

The Health Inequalities Intervention Tool has been commissioned by the Department of Health through the Association of Public Health Observatories (APHO). The tool is designed to assist commissioners in Spearhead Primary Care Trusts (PCTs) with their Local Delivery Planning (LDP) and commissioning and to assist Spearhead Local Authorities (LAs) with the delivery of Local Area Agreements (LAAs). It highlights key issues for Spearhead PCTs and LAs to consider in order to achieve the life expectancy element of the Government's Public Service Agreement (PSA) on health inequalities by 2010

Director of Public Health annual report 2011 and core tables 2010

Too many children and young people are living in circumstances that make it difficult for them to thrive. That is the key message from the third Annual Report of the Director of Public Health (DPH) for Northern Ireland, which was published on 14th June 2012. This significant report highlights the many public health challenges that affect people in Northern Ireland.As Director of Public Health, Dr Carolyn Harper's report describes the main public health challenges across Northern Ireland, and details work being undertaken by the Public Health Agency (PHA) and its partners over the past year to improve the health and wellbeing of people here.A Core Tables report for 2010, available below, produced by the PHA in support of the Director of Public Health's Annual Report for 2011-2012, including information such as estimated home population figures and projections, births information, fertility rates, death rates, information on mortality, life expectancy, immunisation rates and screening uptake rates.

Director of Public Health Annual Report 2014

This is the sixth Director of Public Health Annual Report, detailing the main public health challenges in Northern Ireland. It also provides information on the wide variety of work undertaken by the PHA and its partners during 2014 to improve the health and social wellbeing of the population. Each year, the report focuses on an overarching area, which this year is ‘Adults aged 18–64 years’. The report structure reflects the main areas of public health action: improving health and reducing inequalities; improving health through early detection; improving health through high quality services; improving health through research; protecting health. For ease of reference, the sections are colour coded. On page 94, the report also lists core tables for 2013 relating to key statistical data on, among others, population, birth and death rates, mortality by cause, life expectancy, immunisation and screening. The PDF document of the Core tables is available below. In addition to the core tables, a specific set of tables relating to various aspects of adults aged 18–64 years are published alongside this report.

A deterministic model to assess the impact of AIDS interventions in countries with generalized HIV epidemic. An application to Botswana

General introductionThe Human Immunodeficiency/Acquired Immunodeficiency Syndrome (HIV/AIDS) epidemic, despite recent encouraging announcements by the World Health Organization (WHO) is still today one of the world's major health care challenges.The present work lies in the field of health care management, in particular, we aim to evaluate the behavioural and non-behavioural interventions against HIV/AIDS in developing countries through a deterministic simulation model, both in human and economic terms. We will focus on assessing the effectiveness of the antiretroviral therapies (ART) in heterosexual populations living in lesser developed countries where the epidemic has generalized (formerly defined by the WHO as type II countries). The model is calibrated using Botswana as a case study, however our model can be adapted to other countries with similar transmission dynamics.The first part of this thesis consists of reviewing the main mathematical concepts describing the transmission of infectious agents in general but with a focus on human immunodeficiency virus (HIV) transmission. We also review deterministic models assessing HIV interventions with a focus on models aimed at African countries. This review helps us to recognize the need for a generic model and allows us to define a typical structure of such a generic deterministic model.The second part describes the main feed-back loops underlying the dynamics of HIV transmission. These loops represent the foundation of our model. This part also provides a detailed description of the model, including the various infected and non-infected population groups, the type of sexual relationships, the infection matrices, important factors impacting HIV transmission such as condom use, other sexually transmitted diseases (STD) and male circumcision. We also included in the model a dynamic life expectancy calculator which, to our knowledge, is a unique feature allowing more realistic cost-efficiency calculations. Various intervention scenarios are evaluated using the model, each of them including ART in combination with other interventions, namely: circumcision, campaigns aimed at behavioral change (Abstain, Be faithful or use Condoms also named ABC campaigns), and treatment of other STD. A cost efficiency analysis (CEA) is performed for each scenario. The CEA consists of measuring the cost per disability-adjusted life year (DALY) averted. This part also describes the model calibration and validation, including a sensitivity analysis.The third part reports the results and discusses the model limitations. In particular, we argue that the combination of ART and ABC campaigns and ART and treatment of other STDs are the most cost-efficient interventions through 2020. The main model limitations include modeling the complexity of sexual relationships, omission of international migration and ignoring variability in infectiousness according to the AIDS stage.The fourth part reviews the major contributions of the thesis and discusses model generalizability and flexibility. Finally, we conclude that by selecting the adequate interventions mix, policy makers can significantly reduce the adult prevalence in Botswana in the coming twenty years providing the country and its donors can bear the cost involved.Part I: Context and literature reviewIn this section, after a brief introduction to the general literature we focus in section two on the key mathematical concepts describing the transmission of infectious agents in general with a focus on HIV transmission. Section three provides a description of HIV policy models, with a focus on deterministic models. This leads us in section four to envision the need for a generic deterministic HIV policy model and briefly describe the structure of such a generic model applicable to countries with generalized HIV/AIDS epidemic, also defined as pattern II countries by the WHO.