Tracking the impact on health and well-being in London

The developing ‘framework of indicators’

..a social determinants approach

Gail Findlay and Mark Gamsu - Independent Consultants working with UCL IoHE

26th March 2012

Health impacts of an economic downturn

• Overall mortality mixed results

• Increase in suicides, parasuicides, infectious disease,

homicides

• Fall in road traffic accidents

• Mental health will suffer in the short/med/long-term

• Long-term impacts on CV and general mortality

• Reduced government spending

Impacts of the economic downturn on…

• …employment: Increased unemployment,

particularly for certain demographics (NEETs, LT

unemployed, disabled); impact on working

conditions?

• …income: Sharp changes because of increased

unemployment debt, poverty

• …housing: more landlord and mortgage

repossessions, homelessness, overcrowding etc.

Potential impacts of the welfare reforms on…

• …employment: Will the reforms increase the number

of people in employment?

• …income: Reduced incomes for most people in receipt

of benefits

• …housing: Changes to LHA and the caps will hit

London disproportionately poverty, homelessness,

overcrowding, internal migration

Population groups likely to be most affected:

• People who become unemployed

• Those newly out of education – NEET

• LT unemployed, disabled, other population groups facing

additional barriers to employment

• Families with children – particularly lone parents and

larger families

• People on means-tested benefits

• People living in private rented accommodation

• People living in certain areas of London

Draft criteria

• Sensitive to short and medium term change• Sensitive to actual and emerging impacts/direction of travel • Available from routinely collected data – but not necessarily

from conventional sources (eg. CVS data)

Providing info about impact:• At different geographical levels: neighbourhood to pan

London • On existing or emerging vulnerable groups• On inequalities

• Potential for modeling/enabling analysis of forward projections/trends

Unemployment

• NEETs• Unemployment rates (by deprivation, ethnicity and other groups)

• People losing jobs - new JSA claimants• People not getting jobs• Long term unemployed• Economically inactive• People coming off benefit to JSA• Nature of vacancies – types of jobs available

versus skills in population

Quality of Work

• Sickness Absence• Number of grievances relating to work place

stress/poor health• PAYE: Registered Self Employed • FT/PT working • Duration of employment contracts

Income - Poverty

• Child Poverty• Pensioner Poverty• Working Age Poverty• Number of people on means tested benefits• Fuel Poverty Measure• Low pay threshold; pay gradient; shifts in profiles

of levels of pay; inequality measures/ratios

Income - Debt

• Number of people in problematic debt• Personal insolvency• Number of people taking doorstep loans• Types of debt - credit card etc• Number of people in mortgage arrears• Number of people in rent arrears• Households in arrears

Income - other

• Take up of and growth of soup kitchens • Purchasing behaviour in large supermarkets• Housing benefit case load and flows

Housing

• Overcrowding and other relevant housing‘ conditions’• Types of tenure in bands of cost• Council and Social Landlord waiting lists; % homes

affordable under LAA

• Number of rough sleepers• Number of young people not in stable accommodation• Temporary Accommodation Utilization• Landlord possession orders• Local housing availability

Health and well-being impact

• Anti-depressant prescribing • Incidence of mental health problems• Referrals for CBT• Suicide and para-suicide• Calls for help - Samaritans• Diagnosis of pulmonary TB and ? other infectious

diseases?• IB/ ESA claims• Changes to GP lists • Alcohol related A&E admissions?

Health and Well-being impact - cont

• New well-being index

Impact on Communities:• Acquisitive crime• Community profiles: eg numbers of betting shops;

pay day lenders; pawn shops; vacant shops/properties

Impact on Children: • Readiness for school• ??

QUESTIONS FOR DISCUSSION

• Comments on the draft framework • …and on any of the suggested indicators?

• Are there any key areas and/ or good indicators missing?

• Suggestions for indicators for children specifically?

• How can we engage local authorities and promote their use of this indicator framework?

• Suggestions of other ‘key players’ we should engage in the development of this framework?

For more information and to feed in comments and ideas on the framework Please contact:

Gail Findlaygail.findlay@live.com

Tel: 07940 743201

Mark Gamsumarkgamsu@btinternet.com

Tel: 07557 375028