The development of social class sensitive proxies for infant mortality at the PCT level: An appraisal of candiate indicators for the commission for health improvement

The main aim of the work is to identify social class-sensitive proxies for infant mortality at Primary Care Trust level that could be used in the CHI performance ratings process for PCTs in 2003/4

Why poor quality of ethnicity data should not preclude its use for identifying disparities in health and healthcare

Background: Data of quality are needed to identify ethnic disparities in health and healthcare and to meet the challenges in governance of race relations. Yet concerns over completeness, accuracy and timeliness have been long-standing and inhibitive with respect to the analytical use of the data. Aims: To identify incompleteness of ethnicity data across routine health and healthcare datasets and to investigate the utility of analytical strategies for using data that is of suboptimal quality. Methods: An analysis by government office regions of ethnicity data incompleteness in routine datasets and a comprehensive review and evaluation of the literature on appropriate analytical strategies to address the use of such data. Results: There is only limited availability of ethnically coded routine datasets on health and healthcare, with substantial variability in valid ethnic coding: although a few have high levels of completeness, the majority are poor (notably hospital episode statistics, drug treatment data and non-medical workforce). In addition, there is also a more than twofold regional difference in quality. Organisational factors seem to be the main contributor to the differentials, and these are amenable-yet, in practice, difficult-to change. This article discusses the strengths and limitations of a variety of analytical strategies for using data of suboptimal quality and explores how they may answer important unresolved questions in relation to ethnic inequalities. Conclusions: Only by using the data, even when of suboptimal quality, and remaining close to it can healthcare organisations drive up quality

Candidate Indicators to Monitor the Impact of the Recession on Public Health: Rapid Scoping Study

To date there have been few efforts to investigate the impact of the current recession on the health of the population through the exploitation of routine official sources of information. One reason for this may be the fact that official statistics on population health and health care utilisation take a significant amount of time to validate, this making them less sensitive as timely indicators of change. Yet there are some sources whose release is timely and which offer potential data to systematically assess the effects of the recession on the health of the population. This report is exploratory in attempting to identify such candidate indicators. Further work is required through consultation and peer review processes to establish more precisely whether these indicators can be populated with routine health data

Managing health inequalities locally: a baseline survey of primary care trusts' experience with health equity audit in the implementation year

Health equity audit (HEA), a pragmatic policy tool to ensure that services and resources are focused on issues that have the highest impact on health inequalities, has now become embedded in the national strategy to tackle these inequalities through a new mandatory requirement that primary care trusts (PCTs) conduct one such audit annually. This study aimed to assess their experience through a national baseline survey in 2004, all PCTs (n = 303) being electronically mailed a questionnaire with non-respondent follow-up. Replies were received from 132 PCTs (44%), a representative sample of PCT diversity, most of whom had completed only a few steps in the audit cycle. Audit topics (most frequently coronary heart disease, smoking cessation, and access issues) and dimensions of inequity (mainly area and deprivation) were agreed through only limited engagement with local strategic partnerships. Local public health networks and multiagency teams were infrequent partners in undertaking the HEA. Most PCTs wanted comparator data, good practice examples, and specific methodological expertise. While significant progress has been made, this survey shows only limited use of HEA as a tool for multisectoral use by PCTs in partnership with others and a focus on intra-PCT comparisons at the expense of those with a wider pool of 'look-a-likes'