3. PUBLIC HEALTH
3.1 "Our Healthier Nation" Green
Paper
3.1a What are the specific public health
targets, how will they be monitored and what are the current baselines?
How does the Department intend to monitor local target setting
and achievement? How will it make information on local targets
available to Parliament?
Our Healthier Nation (OHN) Targets proposed in
the Green Paper
1. The proposed public health targets published
in the Green Paper "Our Healthier Nation", which are
subject to public consultation, are listed below. Depending on
the results of the consultation, these may change. A final set
of targets will be published in the White Paper, scheduled for
the autumn.
Circulatory diseases
OHN target proposed:
To reduce the death rate from heart disease and
stroke and related diseases (ie all circulatory diseases combined)
among people aged under 65 by at least one third (33 per cent)
by the year 2010 from a baseline at 1996.
Cancers
OHN target proposed:
To reduce the death rate from all cancers combined
among people aged under 65 by at least one fifth (20 per cent)
by the year 2010 from a baseline at 1996.
Suicide and undetermined injury
OHN target proposed:
To reduce the rate of suicide and undetermined
injury deaths for all ages by at least one sixth(17 per cent)
by the year 2010 from a baseline at 1996.
Accidents
OHN target proposed:
To reduce the rate of occurrence of "major"
accidents (defined as those accidents requiring medical attention
at a hospital or by a family doctor) for all people aged 2 and
above by at least one fifth (20 per cent) by the year 2010 from
a baseline at 1996.
Technical Notes to accompany target specifications
Baseline year:
Mortality targets: the average of the European
age standardised rates for the three years 1995, 1996 and 1997.
NB 1997 data will not be available until later in 1998.
Major accident target: the average of the major
accident rates for the years 1995 and 1996.
Sources of data:
Mortality targets: Office for National Statistics
(ONS) mortality statistics from death registrations. Mortality
rates are age standardised to allow for changes in the age structure
of the population (using the European standard population as defined
by the WHO).
Major accident target: Estimated major accident
rates from the Health Survey for England.
Definitions:
Heart Disease and Stroke and related conditions—includes
all circulatory diseases—International Classification
of Diseases (ICD) codes 390-459 inclusive.
Cancer—all malignant neoplasms—ICD
codes 140-208 inclusive.
Suicide—suicide and undetermined injury—ICD
codes (E950-E959) plus (E980-E989) minus E988.8.
Accidents—a "major" accident
is one which is sufficiently severe to require medical attention
either in hospital or from a family doctor. Respondents to the
Health Survey for England are asked if they had had one or more
major accident in the 6 months prior to interview. For children
aged 2-15, an adult is asked to respond on their behalf.
Monitoring and reporting of targets
2. The specific public health targets referred
to above will be monitored using available national data. If the
targets proposed in the Green Paper are adopted as the final targets,
then they will be monitored using the data sources listed above.
Further advice on monitoring progress and measuring improvements
in health will be provided by the expert members of the Chief
Medical Officer's Our Healthier Nation Working Group.
Current baselines for the targets
3. The final data to be used in White Paper
will be for 1995-97 (for the mortality targets covering circulatory
diseases, cancers and suicide) and 1995-96 (for major accident
morbidity). 1997 mortality data will not be available until later
in 1998.
4. The current available data relate to
1994-96 (for mortality) and 1995-96 (for major accident morbidity),
and the current estimates for the national baselines are shown
in Table 3.1a.
