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Health and Wellbeing in Tower Hamlets

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					Health Inequalities in East
         London
     Health Equity in Primary Care Conference
                      15th July
Dr Somen Banerjee, Associate Director Public Health
               NHS Tower Hamlets
Over the past decade health has improved across East London but health
inequalities persist
CHD       Diabetes




 Stroke      COPD
Inner North East London Boroughs remain the most deprived in London…
..and this remains the most important cause of health inequalities….
There are also significant health inequalities within boroughs….



                                                                   The life
                                                                   expectancy
                                                                   of a boy
                                                                   born in
                                                                   Millwall is 8
                                                                   years
                                                                   higher than
                                                                   one born in
                                                                   Stepney
Health inequalities between different ethnic groups…..
Health inequalities between men and women….
And variations in the extent of gender health inequalities within boroughs….
Older people in East London rate their health poorer than elsewhere…
..and have poorer health outcomes ……
A framework for action                               New White Paper:
                                                     Local Authority
(Fair Society, Healthy Lives – The Marmot Review)…   Health and
                                                     Wellbeing Boards
                                                     as Borough
                                                     oversight body to
                                                     drive this?
The NHS role in tackling inequalities in life expectancy..
Cholesterol and blood pressure control in Inner North East London
practices is generally comparable or better than London….

                                                                               Blood Pressure and Cholesterol Control in Inner East London (2008/9)
                                                                  95.00%
  Percentage Controlled (exceptions exlcluded from denominator)




                                                                  90.00%



                                                                  85.00%



                                                                  80.00%



                                                                  75.00%

                                                                                                                                                                                            LONDON
                                                                  70.00%                                                                                                                    C&H
                                                                                                                                                                                            TH

                                                                  65.00%                                                                                                                    NH



                                                                  60.00%



                                                                  55.00%



                                                                  50.00%
                                                                           CHD6 % Last BP 150/90 or less   CHD8 % Total Cholesterol <    DM12 % Last BP < 145/85   DM17 % Cholesterol < 5
                                                                                                                   5mmol/l

                                                                                                                               QOF indicators
                                                                                                                       No. of quitters




     Below 90% of plan RED
                                                                               0
                                                                                             500
                                                                                                       1,000
                                                                                                                       1,500
                                                                                                                                     2,000
                                                                                                                                               2,500
                                                                                                                                                             3,000




                             90-100% of plan AMBER
                                                     Over 100% of plan GREEN
                                            Ealing
                                             Brent
                                          Camden
                                           Harrow
                                          Lambeth
                                         Hounslow
                                    Waltham Forest
                                          Croydon
             Wandsworth
            Westminster
               Redbridge
                Kingston
                   Enfield
         Sutton & Merton
                 Islington
               Hillingdon
Richmond & Twickenham
              Greenwich
                Haringey
    Barking & Dagenham
                   Barnet
   Kensington & Chelsea
 Hammersmith & Fulham
                                                                                                                                                                     YTD Q4 09/10 Smoking Quitters % Difference from Plan




                                                   Newham
                                                   Havering
                                                 Southwark
                                            City & Hackney
                                                     Bexley
                                                                                                                                                                                                                            Smoking cessation services in Inner North East London boroughs are




                                                    Bromley
                                                  Lewisham
                                                                                                                                                                                                                            performing well and have significantly exceeded their smoking targets..




                                              Tower Hamlets
                                                                                                                       0%
                                                                                                                               10%
                                                                                                                                        20%
                                                                                                                                              30%
                                                                                                                                                       40%
                                                                                                                                                             50%




                                                                               -50%
                                                                                      -40%
                                                                                              -30%
                                                                                                     -20%
                                                                                                               -10%




                                                                                                                      % difference to plan
But we need to ensure that that the benefits are equitable..
                                                    Understanding what
                                                    works in targeting
                                                    groups and geographies
             Rich insight into
             inequalities within
             the population




Collaboration of
commissioners,
clinicians, patients
based on shared                                                      Monitoring
commitment to                                                        against equity
reducing heatlh                                                      dimensions
inequalities




              Evaluating
              equity impact                                     Insights from
              of pathways                                       groups with
                                                                poorer health
                                                                outcomes
Which is why the Health Equity Project is so important…..



           1. The NHS should be for everyone
           whatever their age, sex, race,
           disability, sexual orientation,
           religion or belief.




          NHS Constitution (Easy Read Version)

				
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