"Local commissioning" is a commonly used phrase, and our political parties all seem agreed that it's a good idea (as witnessed in their various annual conferences this month). But how can you apply that concept to health promotion for young people?
We've recently conducted an analysis of results from Lancashire, where surveys from across the county were conducted during 2007 and 2008. Lancashire is a big place, but we were able to break down the sample by district. There were 12 districts represented in the survey: Burnley, Chorley, Fylde, Hyndburn, Lancaster, Pendle, Preston, Ribble Valley, Rossendale, South Ribble, West Lancashire and Wyre.
For any question in the survey, we can look at the results by district. If we are interested in Emotional Health and Well-being, we can see that Exams and Tests are the most important worry for most Year 6 pupils.
Results for this question are shown for Year 6 pupils, by district, in the chart below. The columns show the percentage answering 'quite a lot' or 'a lot' to the question 'How much do you worry... about Exams and SATs?'. [The letters A-L represent each of the districts, although not in the same order as above.]
The spots on the chart represent the 95% confidence limits for each result; we are 95% confident that the true population figure lies within these limits, allowing for sampling error.
Worrying about SATs in Year 6, by district
Actually, we will get some scatter amongst any set of 12 readings of the same measure. So, before looking at these figures with serious intent, we must ask if the amount of scatter is no more as we would expect by chance (analysis of variance [ANOVA]). ANOVA says no [F=2.63, p = 0.002], there is actually more scatter among districts than we would expect by chance alone - so there is a point in looking at the results by district. Looking at the chart, we can see some high (K) and low (L) results, and ANOVA suggests that these are likely really different. [Where the confidence limits overlap substantially (J and K), it is likely that they are not different.] We suggest that there's an argument in districts E, H, J and K for reviewing how their schools manage exam nerves.
What are the hotspots for emotional health in your authority?