Secondary analyses of HSE data and linked health outcomes - an overview of work in progress. UCL (University College London)

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1 Secondary analyses of HSE data and linked health outcomes - an overview of work in progress Dr Jennifer Mindell, UCL (University College London)

2 Linked HSE mortality data (2008) In 2008, some mortality data provided by ONS: o HSE o Deaths to March 2008 Will not be archived or publicised until regular updates organised Released to a few named researchers by NatCen after detailed review by their Data Release Panel

3 IJE cohort paper In preparation!

4 Published studies include: Hamer M, Ingle L, Carroll S, Stamatakis E. Physical Activity and Cardiovascular Mortality Risk: Possible Protective Mechanisms? Med Sci Sports Exerc Jun 8. [Epub ahead of print] o HSE + SHeS data o average follow up 7.0y ± 3.1y o 446 deaths (213 CVD)

5 Participation in MVPA x3 pw associated with lower risk of CVD death (HR= % CI ) Association between physical activity and CVD death: o BMI + Total:HDL-cholesterol + diabetes explained 12.8% o Inflammatory risk factors explained 15.4%

6 Body mass index, waist circumference and waist-hip ratio: which is the better discriminator of cardiovascular disease mortality risk? Czernichow S, Kengne AP, Stamatakis E, Hamer M, Batty GD. Obes Rev Apr 27. doi: /j X x. [Epub ahead of print]

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8 Data adjusted for Age Sex Social class Survey (HSE / SHeS) & Year Smoking Physical activity S-r CVD S-r Diabetes Systolic BP Total cholesterol BMI: U-shaped curve WC: threshold? WHR: threshold Men; linear Women

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10 Physical activity behaviour and coronary heart disease mortality among South Asian people in the UK: an observational longitudinal study. Williams ED, Stamatakis E, Chandola T, Hamer M. Heart. 2011;97(8): HSE 1999 & 2004

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12 Adjusted HRs (with 95% CIs) for ethnicity on coronary heart disease mortality

13 Adjusted HRs (with 95% CIs) for ethnicity on coronary heart disease mortality

14 Physical inactivity explained >20% of the excess CHD mortality in the South Asian sample, even after adjustment for potential confounding variables: o socioeconomic position, smoking, diabetes o socioeconomic position, smoking, diabetes and existing cardiovascular disease.

15 The combined influence of hypertension and common mental disorder on all-cause and cardiovascular disease mortality Hamer M, Batty GD, Stamatakis E, Kivimaki M. J Hypertens. 2010;28(12): HSE data Hypertension has a stronger association with total and CVD mortality in people with a GHQ-12 score of 4

16 Linked HSE mortality data (2011) NatCen has just received the latest update of Mortality records from ONS, though some delay in IC implementing new procedures that will increase automated matching Some data will / may / probably be archived later in 2011 More detailed data may be available from NatCen via their Data Release Panel

17 Kelly Ward is currently working on this ONS potentially want NatCen and individual researchers to reapply for permission on what we do with the data even though they previously agreed - its more red tape Information will go onto the IC website when data are available, to alert people Archive -? Whether flagged; dead / alive; Ca / CVD / Resp / Other; Year of death or Age at death Information about it would go onto the UK Data Archive only if there were data there.

18 HSE linked Hospital Episodes Statistics NatCen is in discussion with the NHS Information Centre about HES data: o what we can have o how we will link this o what we can or can't do with the data etc What will be available on the archive, what will be available from NatCen, what won t be available - still being negotiated

19 Linkage of multiple databases Hamer M, Stamatakis E. Physical activity and mortality in men and women with diagnosed cardiovascular disease. Eur J Cardiovasc Prev Rehabil. 2009;16(2): Scottish Health Surveys (1995, 1998, 2003) Linked to patient-based database of CVD hospital admissions and deaths o 837 adults with clinically confirmed CVD at baseline o 175 died o follow-up average 5.6y +/-3.1y

20 Linkage of multiple databases Men and women with existing CVD who participate in moderate-to-vigorous activity for at least 20 min pw showed the lowest risks of all-cause mortality: o fully adjusted hazard ratio=0.32 (95% CI ) for sport o fully adjusted hazard ratio=0.74 ( ) for walking Similar associations observed for CVD mortality. The physically active also showed o inflammatory risk markers o HDL cholesterol.

21 Cancer data Cancer mortality Incident cancer

22 Diabetes, hyperglycaemia and cancer incidence and mortality Vanessa Gordon-Dseagu

23 Preliminary results: Cancer among the HSE and SHeS cohort at baseline Cancer among diabetic (%) Cancer nondiabetic (%) HSE SHeS Total 3.0 (n=261) 1.8 (n=3,458)

24 How do I access HSE mortality data? If people are interested in accessing this data they should contact Susan Nunn, the HSE Data Manager (susan.nunn@natcen.ac.uk) who will oversee their application process. The application would ordinarily be: o reviewed by NatCen s internal Data Release Panel, o probably by the NHS Information Centre o - and quite possibly ONS too.