Frequently Asked Questions (FAQs) about the Health Profiles

The following FAQs are available (The older Health Profiles 2006 FAQs are also available):

Added Value
Feedback
Indicators
1. Choice
2. Gaps
3. Data
4. Changes
Making appropriate comparisons by time and place
1. Place
2. Time
Other publications
1. In HP family
2. Other public health intelligence
Using profiles
1. Inappropriate use
2. Intended uses
3. Policy relevance
4. Copying into other documents

1 Added value

What is special about the Health Profiles?
The Health Profiles have been produced for local authority areas across England. There is a profile for 386 of the 388 local authorities in England: County Councils, District Councils, Unitary Authorities and London Boroughs. (There is no profile for the City of London and the Isles of Scilly. Due to their small populations, the number of people represented in many of the health profile indicators is small and not statistically robust.)

2 Feedback

What sort of feedback are you looking for?
We would be delighted to get feedback on the content and format of the profiles as well as how they have been used to support local action. Feedback can be submitted via the website.

3 Indicators

(a) Choice

How did you choose the indicators?
We included an indicator if it met the following criteria:

It has an important effect on the health of the local population
It can support local government and NHS management processes
It is valid. This means that it measures what it tries to measure
It is primarily based on existing indicators which are consistently available for every council in England
It is primarily available at Local Authority level. These include County Councils, District Councils, Unitary authorities and London Boroughs
It is possible to make meaningful comparisons over time and between places or people
It can be communicated easily to a wide audience.

(b) Gaps

Why are there gaps?
Where there are gaps, that is because the indicator is important to describing the health of the population but the data are currently not available for all local authority areas in England.

(c) Data

Will we be able to look at the data behind these indicators and profiles?
At present only the completed profiles are available. It is planned that data and further information will be available for local use before the end of 2007.

(d) Changes

Why have some of the indicators changed from those used in Health Profiles 2006?
The Association of Public Health Observatories produced prototype Health Profiles for each local authority in England for the first time in 2006. An extensive evaluation of the profiles was undertaken in Autumn 2006 to inform the production of the 2007 Health Profiles.

Following on from the evaluation changes to the indicators included in the health profiles 2007 were made to result in an improved product. Of the 30 indicators in the health summary 21 have remained the same or have minor modifications, 5 are new improved indicators and 5 have continued to be gaps (one less than last year). For further details on each of the indicators please see the User Guide.

4 Making appropriate comparisons by time and place

(a) Place

What geographical options were considered for the Health Profiles?
Wards, Local Authorities, Counties, Super Output Areas, PCTs.

Why use local authority geography?
Local Authority is a generic term for any level of local government in the UK. In geographic terms LAs therefore include English counties, non-metropolitan districts, metropolitan districts, unitary authorities and London boroughs; Welsh unitary authorities; Scottish council areas; and Northern Irish district council areas.

Historically many health-related datasets are available at local authority level. LAs are important institutions for delivering interventions to improve health and reduce inequalities. Local authorities have a statutory duty to improve the wellbeing of local people and scrutinise local health services. All local authorities have a community plan which outlines the action that they intend to take to improve conditions in their local area. Health Profiles aim to inform local community plans.

Local Area Agreements (LAAs) are in place across local authorities in England and the profiles should help to monitor these agreements.

Why not use Primary Care Trust geography?
The geography of Primary Care organisations has been unstable over the last decade. The number of PCTs in England was reduced from 303 to 152 in autumn 2006. The new configurations improve the co-terminosity of PCTs with local authorities. Only certain health-related datasets are currently available at PCT level.

Were all the numerator and denominator datasets derived from data appropriate to local authority boundaries?
Some indicator datasets are not necessarily derived from data collection based on local authority boundaries.

There is the potential for error when considering the dataset (people with diabetes) generated by the primary care Quality and Outcomes Framework (QoF), which is collected at practice level and aggregated to PCT level. Practices were apportioned to LAs in order to give an LA figure to produce a national LA-General practice table with the proportions of LA populations in each practice. Therefore caution is advised in interpreting this indicator in areas where there is significant utilisation of primary care services outside the PCT boundary.

We would therefore recommend that when interpreting and drawing conclusions from the information presented in the HPs, the metadata document is consulted. This can be found in the User Guide.

(b) Time

If each local authority health profile is titled ‘Health Profile for (name of LA) 2007’ why do the maps, charts and indicators, featured in the spine charts, not feature 2006/07 data?
Health Profiles use the most recently published datasets for numerator data and latest available actual or modelled estimates for denominator population data synchronous with the numerator time period. Because of variation in the publication dates of the datasets used, some indicators may appear old or out of date. For example children in poverty is derived from the 2004 IMD, but the data within IMD 2004 is predominantly 2001 derived from the 2001 census. Similarly, the ‘feeling in poor health’ indicator is derived from the 2001 census. By contrast violent offences is more up to date, as the data is published quarterly with HP figures based on 2005/06.

5 Other publications

(a) In HP family

What about the picture nationally?
The Health Profile of England was published in October 2006, as part of Health Challenge England.

(b) Other public health intelligence

How do these Profiles compare with similar reports produced by other organisations such as the Audit Commission?
The Health Profiles were commissioned by the Department of Health and are a valuable tool for planning action to improve health and reduce health inequalities. They can be used together with local information and other indicator sets and reports to identify where action needs to be taken to improve health and where improvement is already happening.

6 Using profiles

(a) Inappropriate use

What is the point of highlighting a local problem? Will this not just create concern among the public locally rather than actually solving it?
It is only by identifying areas of concern that action can be taken. Local authorities and primary care trusts have a statutory duty to improve the health and wellbeing of the local population. With information like that in the profiles we can all see where there are areas of concern and then take action to improve the health of local communities.

Will these lead to the publication of league tables showing how each area compares with others and year on year changes?
Profiles will be updated every year and will be able to show changes in the local position. They have not been designed to produce league tables.

Is the complete set of Profiles available on a website for comparison purposes?
Yes, www.communityhealthprofiles.info

(b) Intended uses

What action do you expect local authorities to take to deal with any problems highlighted by the profiles?
Local authorities have a statutory duty to improve the wellbeing of local people and scrutinise local health services.
All local authorities have a community plan which outlines the action that they are taking to improve conditions in their local area. Health Profiles will inform local community plans. Local Area Agreements (LAAs) are in place across local authorities in England and the profiles should help to monitor these agreements. (LAAs are voluntary, three-year agreements between central government, local authorities and their partners. They aim to deliver national outcomes in a way that reflects local priorities.)

(c) Policy relevance

What support is available from the Government to help us take action?
As part of delivering the Department of Health’s White Paper ‘Choosing Health’, monies were made available to improve health and reduce health inequalities. The profiles can help prioritise the best use of those resources.

What is “small change: Big Difference”?
The “small change: Big Difference” (sc:BD) initiative encourages people to make small changes in their lifestyles to give them a better chance of living longer, healthier lives. The objective of the initiative is to encourage people to take a step towards achieving the recommended healthy eating and physical activity targets, by highlighting the fact that a small but sustained change in lifestyle – taking moderate exercise and eating one extra portion of fruit or serving of vegetables every day – can make a significant difference to life expectancy. Lifestyle change does not have to be an all or nothing exercise. Every step towards achieving the recommended targets counts. The initiative was launched on the 25 April 2006 by the Prime Minister Tony Blair with Secretary of State Patricia Hewitt. For more information visit www.dh.gov.uk/smallchange

(d) Copying into other documents

Can part /all of a Health Profile be reproduced / cut and pasted into other documents?
Yes providing the document is for non commercial purposes and that there is explicit acknowledgement / referencing of the Health Profiles source material. Health profiles material may be referenced as follows: