SUMMARYThis analysis, designed and executed by Ribble Rivers Trust, identifies areas across England with the greatest levels of physical illnesses that are linked with obesity and inactivity. Please read the below information to gain a full understanding of what the data shows and how it should be interpreted.ANALYSIS METHODOLOGYThe analysis was carried out using Quality and Outcomes Framework (QOF) data, derived from NHS Digital, relating to:- Asthma (in persons of all ages)- Cancer (in persons of all ages)- Chronic kidney disease (in adults aged 18+)- Coronary heart disease (in persons of all ages)- Diabetes mellitus (in persons aged 17+)- Hypertension (in persons of all ages)- Stroke and transient ischaemic attack (in persons of all ages)This information was recorded at the GP practice level. However, GP catchment areas are not mutually exclusive: they overlap, with some areas covered by 30+ GP practices. Therefore, to increase the clarity and usability of the data, the GP-level statistics were converted into statistics based on Middle Layer Super Output Area (MSOA) census boundaries.For each of the above illnesses, the percentage of each MSOA’s population with that illness was estimated. This was achieved by calculating a weighted average based on:- The percentage of the MSOA area that was covered by each GP practice’s catchment area- Of the GPs that covered part of that MSOA: the percentage of patients registered with each GP that have that illnessThe estimated percentage of each MSOA’s population with each illness was then combined with Office for National Statistics Mid-Year Population Estimates (2019) data for MSOAs, to estimate the number of people in each MSOA with each illness, within the relevant age range.For each illness, each MSOA was assigned a relative score between 1 and 0 (1 = worst, 0 = best) based on:A) the PERCENTAGE of the population within that MSOA who are estimated to have that illnessB) the NUMBER of people within that MSOA who are estimated to have that illnessAn average of scores A & B was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer to 1 the score, the greater both the number and percentage of the population in the MSOA predicted to have that illness, compared to other MSOAs. In other words, those are areas where a large number of people are predicted to suffer from an illness, and where those people make up a large percentage of the population, indicating there is a real issue with that illness within the population and the investment of resources to address that issue could have the greatest benefits.The scores for each of the 7 illnesses were added together then converted to a relative score between 1 – 0 (1 = worst, 0 = best), to give an overall score for each MSOA: a score close to 1 would indicate that an area has high predicted levels of all obesity/inactivity-related illnesses, and these are areas where the local population could benefit the most from interventions to address those illnesses. A score close to 0 would indicate very low predicted levels of obesity/inactivity-related illnesses and therefore interventions might not be required.LIMITATIONS1. GPs do not have catchments that are mutually exclusive from each other: they overlap, with some geographic areas being covered by 30+ practices. This dataset should be viewed in combination with the ‘Health and wellbeing statistics (GP-level, England): Missing data and potential outliers’ dataset to identify where there are areas that are covered by multiple GP practices but at least one of those GP practices did not provide data. Results of the analysis in these areas should be interpreted with caution, particularly if the levels of obesity/inactivity-related illnesses appear to be significantly lower than the immediate surrounding areas.2. GP data for the financial year 1st April 2018 – 31st March 2019 was used in preference to data for the financial year 1st April 2019 – 31st March 2020, as the onset of the COVID19 pandemic during the latter year could have affected the reporting of medical statistics by GPs. However, for 53 GPs (out of 7670) that did not submit data in 2018/19, data from 2019/20 was used instead. Note also that some GPs (997 out of 7670) did not submit data in either year. This dataset should be viewed in conjunction with the ‘Health and wellbeing statistics (GP-level, England): Missing data and potential outliers’ dataset, to determine areas where data from 2019/20 was used, where one or more GPs did not submit data in either year, or where there were large discrepancies between the 2018/19 and 2019/20 data (differences in statistics that were > mean +/- 1 St.Dev.), which suggests erroneous data in one of those years (it was not feasible for this study to investigate this further), and thus where data should be interpreted with caution. Note also that there are some rural areas (with little or no population) that do not officially fall into any GP catchment area (although this will not affect the results of this analysis if there are no people living in those areas).3. Although all of the obesity/inactivity-related illnesses listed can be caused or exacerbated by inactivity and obesity, it was not possible to distinguish from the data the cause of the illnesses in patients: obesity and inactivity are highly unlikely to be the cause of all cases of each illness. By combining the data with data relating to levels of obesity and inactivity in adults and children (see the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ dataset), we can identify where obesity/inactivity could be a contributing factor, and where interventions to reduce obesity and increase activity could be most beneficial for the health of the local population.4. It was not feasible to incorporate ultra-fine-scale geographic distribution of populations that are registered with each GP practice or who live within each MSOA. Populations might be concentrated in certain areas of a GP practice’s catchment area or MSOA and relatively sparse in other areas. Therefore, the dataset should be used to identify general areas where there are high levels of obesity/inactivity-related illnesses, rather than interpreting the boundaries between areas as ‘hard’ boundaries that mark definite divisions between areas with differing levels of these illnesses. TO BE VIEWED IN COMBINATION WITH:This dataset should be viewed alongside the following datasets, which highlight areas of missing data and potential outliers in the data:- Health and wellbeing statistics (GP-level, England): Missing data and potential outliersDOWNLOADING THIS DATATo access this data on your desktop GIS, download the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ dataset.DATA SOURCESThis dataset was produced using:Quality and Outcomes Framework data: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.GP Catchment Outlines. Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. Data was cleaned by Ribble Rivers Trust before use.COPYRIGHT NOTICEThe reproduction of this data must be accompanied by the following statement:© Ribble Rivers Trust 2021. Analysis carried out using data that is: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.CaBA HEALTH & WELLBEING EVIDENCE BASEThis dataset forms part of the wider CaBA Health and Wellbeing Evidence Base.

SUMMARYThis analysis, designed and executed by Ribble Rivers Trust, identifies areas across England with the greatest levels of physical and mental illnesses that are linked with obesity and inactivity. Please read the below information to gain a full understanding of what the data shows and how it should be interpreted.ANALYSIS METHODOLOGYThe analysis was carried out using Quality and Outcomes Framework (QOF) data, derived from NHS Digital, relating to:- Asthma (in persons of all ages)- Cancer (in persons of all ages)- Chronic kidney disease (in adults aged 18+)- Coronary heart disease (in persons of all ages)- Depression (in adults aged 18+)- Diabetes mellitus (in persons aged 17+)- Hypertension (in persons of all ages)- Stroke and transient ischaemic attack (in persons of all ages)This information was recorded at the GP practice level. However, GP catchment areas are not mutually exclusive: they overlap, with some areas covered by 30+ GP practices. Therefore, to increase the clarity and usability of the data, the GP-level statistics were converted into statistics based on Middle Layer Super Output Area (MSOA) census boundaries.For each of the above illnesses, the percentage of each MSOA’s population with that illness was estimated. This was achieved by calculating a weighted average based on:- The percentage of the MSOA area that was covered by each GP practice’s catchment area- Of the GPs that covered part of that MSOA: the percentage of patients registered with each GP that have that illness The estimated percentage of each MSOA’s population with each illness was then combined with Office for National Statistics Mid-Year Population Estimates (2019) data for MSOAs, to estimate the number of people in each MSOA with each illness, within the relevant age range.For each illness, each MSOA was assigned a relative score between 1 and 0 (1 = worst, 0 = best) based on:A) the PERCENTAGE of the population within that MSOA who are estimated to have that illnessB) the NUMBER of people within that MSOA who are estimated to have that illnessAn average of scores A & B was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer to 1 the score, the greater both the number and percentage of the population in the MSOA predicted to have that illness, compared to other MSOAs. In other words, those are areas where a large number of people are predicted to suffer from an illness, and where those people make up a large percentage of the population, indicating there is a real issue with that illness within the population and the investment of resources to address that issue could have the greatest benefits.The scores for each of the 8 illnesses were added together then converted to a relative score between 1 – 0 (1 = worst, 0 = best), to give an overall score for each MSOA: a score close to 1 would indicate that an area has high predicted levels of all obesity/inactivity-related illnesses, and these are areas where the local population could benefit the most from interventions to address those illnesses. A score close to 0 would indicate very low predicted levels of obesity/inactivity-related illnesses and therefore interventions might not be required.LIMITATIONS1. GPs do not have catchments that are mutually exclusive from each other: they overlap, with some geographic areas being covered by 30+ practices. This dataset should be viewed in combination with the ‘Health and wellbeing statistics (GP-level, England): Missing data and potential outliers’ dataset to identify where there are areas that are covered by multiple GP practices but at least one of those GP practices did not provide data. Results of the analysis in these areas should be interpreted with caution, particularly if the levels of obesity/inactivity-related illnesses appear to be significantly lower than the immediate surrounding areas.2. GP data for the financial year 1st April 2018 – 31st March 2019 was used in preference to data for the financial year 1st April 2019 – 31st March 2020, as the onset of the COVID19 pandemic during the latter year could have affected the reporting of medical statistics by GPs. However, for 53 GPs (out of 7670) that did not submit data in 2018/19, data from 2019/20 was used instead. Note also that some GPs (997 out of 7670) did not submit data in either year. This dataset should be viewed in conjunction with the ‘Health and wellbeing statistics (GP-level, England): Missing data and potential outliers’ dataset, to determine areas where data from 2019/20 was used, where one or more GPs did not submit data in either year, or where there were large discrepancies between the 2018/19 and 2019/20 data (differences in statistics that were > mean +/- 1 St.Dev.), which suggests erroneous data in one of those years (it was not feasible for this study to investigate this further), and thus where data should be interpreted with caution. Note also that there are some rural areas (with little or no population) that do not officially fall into any GP catchment area (although this will not affect the results of this analysis if there are no people living in those areas).3. Although all of the obesity/inactivity-related illnesses listed can be caused or exacerbated by inactivity and obesity, it was not possible to distinguish from the data the cause of the illnesses in patients: obesity and inactivity are highly unlikely to be the cause of all cases of each illness. By combining the data with data relating to levels of obesity and inactivity in adults and children (see the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ dataset), we can identify where obesity/inactivity could be a contributing factor, and where interventions to reduce obesity and increase activity could be most beneficial for the health of the local population.4. It was not feasible to incorporate ultra-fine-scale geographic distribution of populations that are registered with each GP practice or who live within each MSOA. Populations might be concentrated in certain areas of a GP practice’s catchment area or MSOA and relatively sparse in other areas. Therefore, the dataset should be used to identify general areas where there are high levels of obesity/inactivity-related illnesses, rather than interpreting the boundaries between areas as ‘hard’ boundaries that mark definite divisions between areas with differing levels of these illnesses. TO BE VIEWED IN COMBINATION WITH:This dataset should be viewed alongside the following datasets, which highlight areas of missing data and potential outliers in the data:- Health and wellbeing statistics (GP-level, England): Missing data and potential outliersDOWNLOADING THIS DATATo access this data on your desktop GIS, download the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ dataset.DATA SOURCESThis dataset was produced using:Quality and Outcomes Framework data: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.GP Catchment Outlines. Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. Data was cleaned by Ribble Rivers Trust before use.COPYRIGHT NOTICEThe reproduction of this data must be accompanied by the following statement:© Ribble Rivers Trust 2021. Analysis carried out using data that is: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.CaBA HEALTH & WELLBEING EVIDENCE BASEThis dataset forms part of the wider CaBA Health and Wellbeing Evidence Base.

SUMMARYThis analysis, designed and executed by Ribble Rivers Trust, identifies areas across England with the greatest levels of obesity, inactivity and inactivity/obesity-related illnesses. Please read the below information to gain a full understanding of what the data shows and how it should be interpreted.The analysis incorporates data relating to the following:Obesity/inactivity-related illnesses (asthma, cancer, chronic kidney disease, coronary heart disease, depression, diabetes mellitus, hypertension, stroke and transient ischaemic attack)Excess weight in children and obesity in adults (combined)Inactivity in children and adults (combined)The analysis was designed with the intention that this dataset could be used to identify locations where investment could encourage greater levels of activity. In particular, it is hoped the dataset will be used to identify locations where the creation or improvement of accessible green/blue spaces and public engagement programmes could encourage greater levels of outdoor activity within the target population, and reduce the health issues associated with obesity and inactivity.ANALYSIS METHODOLOGY1. Obesity/inactivity-related illnessesThe analysis was carried out using Quality and Outcomes Framework (QOF) data, derived from NHS Digital, relating to:- Asthma (in persons of all ages)- Cancer (in persons of all ages)- Chronic kidney disease (in adults aged 18+)- Coronary heart disease (in persons of all ages)- Depression (in adults aged 18+)- Diabetes mellitus (in persons aged 17+)- Hypertension (in persons of all ages)- Stroke and transient ischaemic attack (in persons of all ages)This information was recorded at the GP practice level. However, GP catchment areas are not mutually exclusive: they overlap, with some areas covered by 30+ GP practices. Therefore, to increase the clarity and usability of the data, the GP-level statistics were converted into statistics based on Middle Layer Super Output Area (MSOA) census boundaries.For each of the above illnesses, the percentage of each MSOA’s population with that illness was estimated. This was achieved by calculating a weighted average based on:The percentage of the MSOA area that was covered by each GP practice’s catchment areaOf the GPs that covered part of that MSOA: the percentage of patients registered with each GP that have that illness The estimated percentage of each MSOA’s population with each illness was then combined with Office for National Statistics Mid-Year Population Estimates (2019) data for MSOAs, to estimate the number of people in each MSOA with each illness, within the relevant age range.For each illness, each MSOA was assigned a relative score between 1 and 0 (1 = worst, 0 = best) based on:A) the PERCENTAGE of the population within that MSOA who are estimated to have that illnessB) the NUMBER of people within that MSOA who are estimated to have that illnessAn average of scores A & B was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer to 1 the score, the greater both the number and percentage of the population in the MSOA predicted to have that illness, compared to other MSOAs. In other words, those are areas where a large number of people are predicted to suffer from an illness, and where those people make up a large percentage of the population, indicating there is a real issue with that illness within the population and the investment of resources to address that issue could have the greatest benefits.The scores for each of the 8 illnesses were added together then converted to a relative score between 1 – 0 (1 = worst, 0 = best), to give an overall score for each MSOA: a score close to 1 would indicate that an area has high predicted levels of all obesity/inactivity-related illnesses, and these are areas where the local population could benefit the most from interventions to address those illnesses. A score close to 0 would indicate very low predicted levels of obesity/inactivity-related illnesses and therefore interventions might not be required.2. Excess weight in children and obesity in adults (combined)For each MSOA, the number and percentage of children in Reception and Year 6 with excess weight was combined with population data (up to age 17) to estimate the total number of children with excess weight.The first part of the analysis detailed in section 1 was used to estimate the number of adults with obesity in each MSOA, based on GP-level statistics.The percentage of each MSOA’s adult population (aged 18+) with obesity was estimated, using GP-level data (see section 1 above). This was achieved by calculating a weighted average based on:The percentage of the MSOA area that was covered by each GP practice’s catchment areaOf the GPs that covered part of that MSOA: the percentage of adult patients registered with each GP that are obeseThe estimated percentage of each MSOA’s adult population with obesity was then combined with Office for National Statistics Mid-Year Population Estimates (2019) data for MSOAs, to estimate the number of adults in each MSOA with obesity.The estimated number of children with excess weight and adults with obesity were combined with population data, to give the total number and percentage of the population with excess weight.Each MSOA was assigned a relative score between 1 and 0 (1 = worst, 0 = best) based on:A) the PERCENTAGE of the population within that MSOA who are estimated to have excess weight/obesityB) the NUMBER of people within that MSOA who are estimated to have excess weight/obesityAn average of scores A & B was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer to 1 the score, the greater both the number and percentage of the population in the MSOA predicted to have excess weight/obesity, compared to other MSOAs. In other words, those are areas where a large number of people are predicted to suffer from excess weight/obesity, and where those people make up a large percentage of the population, indicating there is a real issue with that excess weight/obesity within the population and the investment of resources to address that issue could have the greatest benefits.3. Inactivity in children and adultsFor each administrative district, the number of children and adults who are inactive was combined with population data to estimate the total number and percentage of the population that are inactive.Each district was assigned a relative score between 1 and 0 (1 = worst, 0 = best) based on:A) the PERCENTAGE of the population within that district who are estimated to be inactiveB) the NUMBER of people within that district who are estimated to be inactiveAn average of scores A & B was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer to 1 the score, the greater both the number and percentage of the population in the district predicted to be inactive, compared to other districts. In other words, those are areas where a large number of people are predicted to be inactive, and where those people make up a large percentage of the population, indicating there is a real issue with that inactivity within the population and the investment of resources to address that issue could have the greatest benefits.Summary datasetAn average of the scores calculated in sections 1-3 was taken, and converted to a relative score between 1 and 0 (1= worst, 0 = best). The closer the score to 1, the greater the number and percentage of people suffering from obesity, inactivity and associated illnesses. I.e. these are areas where there are a large number of people (both children and adults) who are obese, inactive and suffer from obesity/inactivity-related illnesses, and where those people make up a large percentage of the local population. These are the locations where interventions could have the greatest health and wellbeing benefits for the local population.LIMITATIONS1. For data recorded at the GP practice level, data for the financial year 1st April 2018 – 31st March 2019 was used in preference to data for the financial year 1st April 2019 – 31st March 2020, as the onset of the COVID19 pandemic during the latter year could have affected the reporting of medical statistics by GPs. However, for 53 GPs (out of 7670) that did not submit data in 2018/19, data from 2019/20 was used instead. Note also that some GPs (997 out of 7670) did not submit data in either year. This dataset should be viewed in conjunction with the ‘Levels of obesity, inactivity and associated illnesses: Summary (England). Areas with data missing’ dataset, to determine areas where data from 2019/20 was used, where one or more GPs did not submit data in either year, or where there were large discrepancies between the 2018/19 and 2019/20 data (differences in statistics that were > mean +/- 1 St.Dev.), which suggests erroneous data in one of those years (it was not feasible for this study to investigate this further), and thus where data should be interpreted with caution. Note also that there are some rural areas (with little or no population) that do not officially fall into any GP catchment area (although this will not affect the results of this analysis if there are no people living in those areas).2. Although all of the obesity/inactivity-related illnesses listed can be caused or exacerbated by inactivity and obesity, it was not possible to distinguish from the data the cause of the illnesses in patients: obesity and inactivity are highly unlikely to be the cause of all cases of each illness. By combining the data with data relating to levels of obesity and inactivity in adults and children, we can identify where obesity/inactivity could be a contributing factor, and where interventions to reduce obesity and increase activity could be most beneficial for the health of the local population.3. It was not feasible to incorporate ultra-fine-scale geographic distribution of