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The Annual Report of the Chief Medical Office 2018 made a case for health as one of the primary assets of the UK, contributing to both the economy and happiness. The report described how we must measure and track progress in our development of health as a nation and our fairness as a society in delivering improving health outcomes.
The report called for a composite Health Index to be developed (see the Chief Medical Officer’s summary, particularly Chapter 1, page 2 link below). Your Public Health Data Science assignment is to create a composite Health Index using PHE Fingertips data disaggregated to small areas (eg. Local Authority or Middle Super Output Areas) in England. As per the CMO report, the index should:
● Be inclusive of health outcome measures, modifiable risk factors and the social determinants of health;
● Be able to be disaggregated by composition and geographical area allowing tracking of performance of each component additional to the overall metric;
On the first face-to-face day you will be given a chance to discuss the assessment in detail. You will then work in groups for the day to begin to tackle the creation of the index along with other tasks that we will set. Whilst you will work on this problem together for the day, it is essential that your final code and report submitted is entirely your own work. The deadline for the coursework submission is Mon 29 April - 12:00pm. Submissions will be made via Moodle.
We would like you to submit an R Markdown file that contains the analysis in addition to a Report that has a maximum of 1,500 words of text (not including analytical code, tables, results or Figures) and contains the following sections:
1. Background
a. A statement of the context and setting
2. Aims
a. A description of the aim for the index you have developed
3. Methods:
a. Description of data items included in the index
b. Description of the methods for creation of the index
4. Results
a. Presentation of the overall index
b. Presentation of disaggregated index
5. Discussion
a. Interpretation of results, including their strengths and weaknesses
b. How the index could be used to improve the health of the public by conducting one of the following:
i. A brief stakeholder analysis
ii. A brief media engagement and dissemination strategy
Public Health Data Science-(CHME0017)
The Health of a Nation
Developing a Composite Health Index for England
Background
In 2018 the Chief Medical Officer called for the development of a Composite Health Index (CHI) to be developed in order to quantify health as a national asset and to track changes in health over time (Davies 2018).
Dahlgren & Whitehead’s (1992) model suggests that health is determined by genetics, life stage, individual risk factors and behaviours, wider social determinants and the interaction between all of these. The variation in risk factors and social determinants is closely linked to deprivation, with the least deprived people having a life expectancy almost 10 years longer than the most deprived, and can expect almost 20 years more without living with a disability (Marmot and Bell 2012). Social determinants of health are mutable with changes in policy within local and central government, growth of GDP, and changes in the distribution of
wealth. Risk factors can be modified through policy and societal change. Health outcomes are a product of social determinants of health and individual risk factors’ interaction with health services, and so health service performance is included.
Tackling health inequalities requires understanding social determinants of health, risk behaviours, and health outcomes, and tracking change over time across the whole population.