Public Health Waltham Forest

Background:
Public Health Waltham Forest required a narrative as to how and why the Indices of Multiple Deprivation (IMD) ranks for Waltham Forest have illustrated increasing deprivation over time amongst all England local authorities from 47th in 2004, to 27th in 2007 and 15th in 2010. 
The IMD is the main source of local deprivation measurement and Public Health staff wanted to ensure that all factors in its results were understood when using it in their own analysis.

What was the problem?
It was unclear if these changes over time were due to relative effects, data effects, or actual absolute increases in deprivation. If increases in deprivation over time were real, this would be important because it may have implications for social and health inequalities in the borough and the drivers of this decline would need to be understood.
In addition, with the last IMD 2010 based on 2008 data, there was a lack of intelligence on deprivation in Waltham Forest post 2008, a period when there have been many significant changes due to economic recession and welfare reform.

How did PHAST help?
A PHAST consultant examined documentation for the last three Indices of Deprivation (ID) and provided summaries of their creation, purpose, recommended uses and changes over time. Waltham Forest’s measures on these Indices were examined including assessing which domains are driving changes. Alternative sources based on local administrative assets were explored to measure deprivation in a more up-to-date and absolute way as at 2009 and 2011 and change in-between. New IMD values were created from these to measure differences between the different sources and how stable they are over time. 
The report concluded that the Indices of Deprivation are not suitable for measuring absolute change in deprivation over time or the causes of change. The income and employment domains were found to contribute the most to changes in average IMD score, and that the employment effect was reduced in 2010 compared to 2007.
The alternative administrative data local intelligence sources found that there had been a change in Waltham Forest between 2009 and 2011 that could indicate increased deprivation based on the increase of the population living in households receiving means tested benefits and living in social housing tenure.
Areas in the south East of Waltham Forest were identified as most vulnerable to unreliable IMD measurements.

What was the Impact?
The PHAST analysis and report was presented to the client and the wider JSNA (Joint Strategic Needs Assessment) group, and was well received. The report was considered very useful in that it provided new up-to-date evidence on deprivation in Waltham Forest and challenged how funding should be allocated on that basis. It was also considered to be relevant to Waltham Forest’s Economic Growth Commission, Health and Wellbeing Board and Management Board’s agendas.