In our last blog post we asked for examples of good data visualisations and two of note were Cancer Research UK's "The causes of cancer you can control" and "Cancer, anyone?" on Visual.ly.
Interestingly, both of these were cancer related – one summarised the contribution of various risk factors such as smoking and alcohol to different forms of cancer. The other, from the US, emphasised prevention.
What we wanted to focus on in this post was showing improvement and trends. In one of our recent posts about health profiles we commented on improvements in teenage conception rates to which one response questioned whether this was true of London. Here’s the data for Lambeth taken from PHE’s Sexual and Reproductive Health profiles.
It shows the teenage conception rates from 1998 to 2012 in Lambeth compared to the England average. The lines with black dots are the England values: coloured dots are local authority values. Dots are coloured red where the values are statistically significantly higher than the national average - in this example where the value in the Lower CI (confidence interval) column is higher than the corresponding value in the England column; yellow if they are consistent with the England average, and green if they are lower.
A few things are clear:
- Teenage pregnancy rates have fallen nationally (the black line) – they fell from 47 conceptions per 1000 women aged 15-17 in 1998 to 28 per 1000 in 2012 with a year on year fall (which seems to have quickened in the last 5 years).
- After an initial increase, rates in Lambeth fell dramatically by about two thirds over a 9 year period
- The rate in Lambeth was slightly above the national average in 2012
What about the rest of London? Here’s the data for some of the more deprived London boroughs. We’ve ordered charts by the latest value so in 2012 Lewisham had the highest rate of this group of local authorities. Teenage conception rates have fallen in all these areas (and indeed all London boroughs) although the pattern of improvement varies.
This pattern is true across England – in virtually all of the 350 or so local authorities teenage pregnancy rates have fallen and in some cases dramatically so. It is also true in the most deprived decile of local authorities.
So why has this improvement happened? We can’t tell from the data but its global nature suggests a wide spread successful intervention, and different patterns in different areas suggest some local variation. The fact that rates haven’t increased since the recession is of note. We had a 10 year teenage pregnancy strategy which started in 1999 with additional funding for local contraception services including long acting reversible contraception (LARC) in 2008. A recent review of the strategy suggests ten key factors are important in this success:
- Sex and relationship education in schools
- Youth friendly contraceptive services
- Consistent messages to young people, parents and practitioners
- Training in sexual health and relationships for health practitioners
- Access to contraception in non-health youth projects
- Targeted outreach prevention for young people at risk
- Good data for commissioning and monitoring
- Support for teenage parents
- Support for parent so discuss sexual health with their children.
- Strong leadership and accountability
So the message is clear: teenage pregnancy rates have fallen across the London and across the country. This is not a chance finding and it isn’t to do with the way we count or collect the data - this is a result of population and public health action. It is a genuine and persistent improvement and the latest data from ONS shows that rates continue to improve - comparing Quarter 2 2013 with Quarter 2 2012, there has been an 11.3% reduction from a rate of 28.4 per 1000 population (6664 conceptions) in 2012 to 25.2 (5905 conceptions) in 2013. The job is not yet done - rates are still higher than Europe - but having data collected consistently over time is crucial to monitoring and evaluating success.
If you know of any interesting or insightful visualisations please let us know.
Featured image via Getty. Used under license.
1 comment
Comment by Andrew Billett posted on
Could you provide a reference to the recent report which reviewed the effectiveness of the teenage pregnancy strategy. I am a public health analyst in an area in the North East where teenage (under 18) conception rates have been falling but not as quickly as the national rate leading to a widening of health inequalities. The list of effective interventions will be useful checkclist to use in any review of local strategy. Hence I would like the full reference back to the original review report.