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Tracking the impact on health and well-being in London

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.

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Tracking the impact on health and well-being in London

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  1. 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

  2. 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

  3. 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.

  4. 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

  5. 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

  6. 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: neighbourhoodto pan London • On existing or emerging vulnerable groups • On inequalities • Potential for modeling/enabling analysis of forward projections/trends

  7. 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

  8. 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

  9. 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

  10. 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

  11. Income - other • Take up of and growth of soup kitchens • Purchasing behaviour in large supermarkets • Housing benefit case load and flows

  12. 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

  13. 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?

  14. 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 • ??

  15. 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?

  16. For more information and to feed in comments and ideas on the frameworkPlease contact: Gail Findlay gail.findlay@live.com Tel: 07940 743201 Mark Gamsu markgamsu@btinternet.com Tel: 07557 375028

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