For some time now political control has been devolving from the centre. Individual regions, local authorities, GP consortia, and even neighbourhood communities are increasingly making decisions about their own area. This localism agenda has broad party support and it’s likely to be part of our governance architecture for the long-term. With it come new responsibilities for decision makers. While we may never fully understand the causes of last week’s riots, local variations in socio-economic circumstances and service provision are likely to have played a role.
So how can decision makers understand and respond to the specific needs of their community, on an ever tighter budget? They could commission local research to find out what their community needs. But one casualty of commissioning locally has been the loss of efficiencies of scale. Good quality survey research needs large samples and control groups for benchmarking and comparison. Without comparable data for the rest of the country, findings are hard to contextualise or interpret.
We propose making better use of existing national data. Our field force of more than a thousand interviewers work in every part of the country, and we’re able to examine regional data in the context of national data. This analysis can help service providers better understand their local populations.
One such report, published recently, used the best national data source on community mental health and wellbeing to profile the East Midlands and make comparisons with the rest of England. Mental Health in the East Midlands: results from the Adult Psychiatric Morbidity Survey 2007 is a report commissioned by NHS East Midlands and the NHS Information Centre. The results of our regional analyses indicate that, as local authorities in the region take on greater responsibility for public health, the East Midlands should focus on diet and exercise and the identification and support of people with depression. These recommendations are based on findings from the report such as:
- Compared with the average for the rest of the country, people living in the East Midlands were more likely to be depressed, although they were not more likely to be anxious. This high rate of depression remained even after regional differences in socio-demographic circumstances were controlled for.
- We also found that while the proportion of people in the East Midlands who killed themselves was similar to the national average, men in the East Midlands were more likely to have made a suicide attempt.
- Adults living in the East Midlands were more likely to have a physical health condition than those living elsewhere. This was particularly pronounced for diabetes, and our survey data show that a likely driver of this is that obesity is more common in the East Midlands than in the rest of England.