One of the biggest enemies of improvements to public health is the invisibility of inequities in health programmes.
Take the NHS’s Health Checks Programme. Designed to reduce mortality and improve prevention and diagnosis, in Kent we need a detailed picture of over 1.5 million residents to understand how it is performing and where we are failing individuals. These failures – or inequities – are systematic differences in public health which can be solved with targeted intervention. But finding these individuals and groups needs data to be at the heart of public health strategy. More importantly, we require higher levels of data integration and detail than ever before.
Four years ago, in response to legislation bringing public health into local government, Kent CC set up the Kent Public Health Observatory (KPHO). Collecting information about the population’s health provides evidence for tracking performance and improvement. For local authorities generally, and public health specifically, there are so many resources that can be used to build up this picture – unfortunately, they are often untapped. This may include 'administrative data', in our case that of health agencies and partners, and publicly-available free and open data. However, rather than simply consulting different datasets, we developed a 'blended data' strategy that brough the data together in one location – the Kent Integrated Dataset (KID).
The KID is designed for a blended data strategy, allowing us to introduce new data sets where they can improve our visibility of health and wellbeing in the local area. This meant we could work with CACI, a partner that works strategically with local government, to blend in their consumer segmentation tool Acorn, which tracks lifestyle, behaviour and attitudes of UK consumers. Via a secure login process we can now access a longitudinal care record spanning health and social care – all at pseudonymised person level.
With an almost ‘cradle-to-grave’ view of public health, at a level of detail previously unavailable to us, we now have a much more nuanced understanding of who is accessing our services. And if they aren’t, we can tailor programmes in the most effective way to remedy issues. This proved crucial in our 2017 Health Checks Equity Audit. Reviewing the NHS Health Checks Programme, we found a range of inequities and made recommendations to overcome them: for example, people in certain deprived segments are being targeted in alternative ways to promote uptake of health checks. Blended and highly detailed data has become a crucial part of our public health strategy, creating a solid evidence base for critical interventions.
Gerrard Abi-Aad is head of health intelligence for Kent CC's Public Health Observatory
Kent CC will be featuring at LARIA's one-day conference at the University of Liverpool on 9 November