Hull Public Health 

The Deep, Hull The Guildhall, Hull King William Statue, Market Place, Hull City Hall, Hull Spurn Lightship, The Marina, Hull

 

 

Prevalence


Documents

The main documents presenting information on the prevalence of disease or behavioural or lifestyle risk factors, or discussing issues associated with synthetic estimates of prevalence or comparing prevalence are detailed below, including:

JSNA
JSNA Toolkit
Problem of Synthetic Estimates
Why QOF Differs Among Practices
Health Equity Audits
Survey reports
JSNA Ward Profiles 2013
JSNA Hull Atlas

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Definition

The (point) prevalence is the proportion of people with the condition in question at a specific point in time out of the total population. The incidence rate is the number of instances of illness commencing, or of persons falling ill, during a given period in a specified population out of the numbers in that population. For further explanation, see the Glossary.

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Benchmarking

Comparator Areas gives details of the comparator areas which are similar to Hull and have been used for benchmarking within the JSNA Toolkit and other local reports. Various factors such as population, ethnicity, deprivation, housing stock, etc are examined in relation to the characteristics of Hull in the Comparator Areas and JSNA Toolkit. These comparator areas are also used within the local analysis of the Public Health Outcomes Framework indicators, and the list can be seen within the Public Health Outcomes Framework Main Report (to open this report on a particular PHOF indicator, click here).

The general practices in Hull differ with regard to their registered population in terms of deprivation and age of patients. Whilst general practices can be compared, it is better and easier to try to compare like-with-like. As a result, the general practices in Hull have been grouped according to the average deprivation score of their patients and the average age of their patients. The General Practice Comparator Groupings document provides further details.

For associated information, also see Geo-demographic Segmentation.

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Modelled / Synthetic Prevalence

Modelled prevalence in the context of the local reports and documents refers to prevalence estimates that are produced through modelling and synthetic data, where an accurate reliable prevalence estimate is not known. Nationally, modelled or synthetic estimates of the prevalence of lifestyle risk factors such as smoking have been produced for each local authority. However, in Hull due to the numerous Surveys completed, robust estimates of prevalence can be made. A modelled or synthetic estimate is only as good as the model and as good as the underlying data from which the model is produced. If modelled estimates are produced for populations that are extreme (such as Hull given its deprivation), then it is quite possible that the derived estimates are poor. This has been the case, in particular, for the national estimate of smoking prevalence for Hull. A full discussion of the Problem of Synthetic Estimates is available, and it is also discussed within the JSNA Toolkit and Glossary.

Modelled prevalence estimates have been produced at practice level using various 'models' for each of the diseases in the Quality and Outcome Framework (QOF) which includes:

Coronary heart disease (CHD)
Stroke and transient ischaemic attack (TIA)
Heart failure
Atrial fibrillation
Hypertension
Diabetes
Epilepsy
Hypothyroidism disease
Asthma
Chronic obstructive pulmonary disease (COPD)
Chronic kidney disease
Severe mental health
Dementia
Learning disabilities
Palliative care

These are then compared with the actual diagnosed number on the QOF disease registers. As mentioned above, there are problems with modelled estimates, but these can be used as a starting point or guide to investigate specific practices that have large differences between the modelled estimate and the register. Details of the models and the modelled estimates and differences between the modelled estimates and the registers are given in the JSNA Toolkit.

The Projecting Older People Population Information (POPPI) System provides population projections for people aged 65+ years for 2011, 2015, 2020, 2025 and 2030 (i.e. predictive modelling). It provides various estimates of the number of people aged 65+ years in Hull are predicted to have specific health needs such as the numbers predicted to be in care homes, who have diabetes, who are obese, who are incontinent, etc.

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Prevalence of Disease

As part of the Quality and Outcomes Framework (QOF), practices need to have registers of patients who have had a diagnosis of that specific disease. More information about QOF is given in the JSNA Toolkit and Glossary. The QOF general practice disease registers cover a range of medical conditions and diseases, and the prevalence of the disease is reported within the disease-specific Hull JSNA Toolkit reports for the following diseases:

Coronary heart disease (CHD)
Stroke and transient ischaemic attack (TIA)
Left ventricular function (2004/05 and 2005/06 only)
Heart failure
Atrial fibrillation
Hypertension
Cancer
Diabetes
Epilepsy
Hypothyroidism disease
Asthma
Chronic obstructive pulmonary disease (COPD)
Chronic kidney disease
Severe mental health
Dementia
Learning disabilities
Palliative care

These are also presented by general practice and by deprivation, as well as examining trends over time among practices.

Some of the issues associated with comparing prevalence figures over all the Hull practices are discussed within the General Practice Comparator Groupings, JSNA Toolkit and Glossary, with more detailed information within the Why QOF Differs Among Practices report. Details of grouping practices into eight groups for benchmarking are given in the General Practice Comparator Groupings.

The prevalence of sexually transmitted infections and of tuberculosis is also given within Hull JSNA Toolkit: Sexual Health and Hull JSNA Toolkit: Infectious Diseases respectively.

The diagnosed prevalence of diabetes as for those aged 17+ years, the crude rate of Chlamydia diagnoses per 100,000 young adults aged 15-24 years, and the tuberculosis incidence are indicators within Public Health Outcomes Framework and further analysis is given within the Public Health Outcomes Framework Main Report (to open this report on a particular PHOF indicator, click here) and Public Health Outcomes Framework Summary.

The following Equity Audits also give further details specific to the diseases in question:

Stroke Equity Audit (September 2011)
Hypertension Equity Audit (February 2011)
Chronic Obstructive Pulmonary Disease Equity Audit (December 2010)
Diabetes Equity Audit (October 2008)
Mental Health Equity Audit (March 2007)
Cancer Equity Audit (July 2006)
Coronary Heart Disease Equity Audit (September 2005)

The incidence of different cancers and the childhood diseases of measles and whooping cough (pertussis) are given within Hull JSNA Toolkit: All Cancers and Hull JSNA Toolkit: Children and Young People respectively.

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Prevalence of Lifestyle Risk Factors and Different Levels of Health / Health Status

The prevalence of different levels of health (e.g. excellent health or poor mental health) and of lifestyle risk factors such as smoking, alcohol consumption, substance abuse, diet, exercise and obesity are given in the Adult and Young People (not obesity) Health and Lifestyle Survey reports as follows:

Young People Health and Lifestyle Survey 2012 Main Report
Young People Health and Lifestyle Survey 2008-09 Main Report
Young People Health and Lifestyle Survey 2002 Main Report
Adult Health and Lifestyle Survey 2014 Main Report
Adult Health and Lifestyle Survey 2011-12 Main Report
BME Health and Lifestyle Survey 2011-12 Main Report
Adult Health and Lifestyle Survey 2007 Main Report
BME Health and Lifestyle Survey 2007 Main Report
Gypsy and Traveller Health and Lifestyle Survey 2007 Main Report
Adult Health and Lifestyle Survey 2009 Main Report
Veteran Health and Lifestyle Survey 2009 Main Report
Adult Health and Lifestyle Survey 2003 Main Report
Adult Health and Lifestyle Survey 2003 Eastern Hull Tables
Adult Health and Lifestyle Survey 2003 West Hull Tables

The prevalence of overweight and obesity among 4-5 and 10-11 year olds is given in the following reports:

NCMP Child Obesity Bulletin 2011/12
Child Obesity Trends to 2010/11

The prevalence of different levels of health and of lifestyle risk factors are also given in JSNA Ward Profiles 2013 and JSNA Hull Atlas.

The local Healthy Heart Study involved collecting information on age, gender, blood pressure, cholesterol, smoking status and whether or not the person had diabetes or not. The information was collated into a score (probability) relating to the '10-year risk of a cardiovascular event'. The definition of the risk of a 10-year cardiovascular event is given within the Glossary document. Further information is given in Hull JSNA Toolkit: Coronary Heart Disease.

The percentage of survey responders with multiple risk factors has been examined within the JSNA Toolkit for both adults and young people, as well as within the disease-specific reports as follows:

Smoking Report 2014
Smoking Summary 2014
Smoking Report 2013
Alcohol Report 2014
Alcohol Summary 2014
Alcohol Report 2013
Physical Activity, Diet and Obesity Report 2014
Obesity, Physical Activity and Diet summary 2014
Diet and Physical Activity Report 2013
Obesity and Overweight Report 2013

Factors which predicted lifestyle and behavioural risk factors are mentioned briefly within the JSNA Toolkit and were examined in detail within the disease-specific reports as follows:

Smoking Report 2007
Obesity and Exercise Report 2007
Alcohol Report 2007

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Public Health Outcomes Framework

There are a number of indicators for the prevalence of disease or lifestyle risk factors within Public Health Outcomes Framework and further analysis is given within the Public Health Outcomes Framework Main Report (to open this report on a particular PHOF indicator, click here) and Public Health Outcomes Framework Summary. These include the diagnosed prevalence of diabetes for those aged 17+ years, the crude rate of Chlamydia diagnoses per 100,000 young adults aged 15-24 years, the tuberculosis incidence, the prevalence of breastfeeding, smoking in pregnancy, overweight and obesity among 4-5 and 10-11 year olds, physical activity (and inactivity) among adults, smoking among adults and self-reported wellbeing.

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