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Public Health Challenges and Opportunities in the West Midlands Local Government’s New Public Health Role – 12th July 2012 Karen Saunders, Senior Public.

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Presentation on theme: "Public Health Challenges and Opportunities in the West Midlands Local Government’s New Public Health Role – 12th July 2012 Karen Saunders, Senior Public."— Presentation transcript:

1 Public Health Challenges and Opportunities in the West Midlands Local Government’s New Public Health Role – 12th July 2012 Karen Saunders, Senior Public Health Manager, Department of Health, West Midlands

2 Overview What we mean by ‘Public Health’ Challenges and health inequalities in the West Midlands Opportunities for action –National context –‘Old and New’ Public Health –The Role of Councillors 2

3 Definition of Public Health ‘ Public Health is the science and art of promoting and protecting health and well- being, preventing ill-health and prolonging life through the organised efforts of society.’ (Source: Faculty of Public Health, adapted from Acheson Report 1988) 3

4 Challenges 4


6 West Midlands Strategic Health Authority (Source: ONS (2011) Life expectancy at birth by local area in the UK, to )

7 West Midlands Strategic Health Authority (Source: ONS (2011) Life expectancy at birth by local area in the UK, to )

8 West Midlands Strategic Health Authority Standardised Mortality Ratio for all causes in people aged under by MSOA - Coventry Source: APHO

9 Inequalities begin from birth Baby Born to affluent parents – will live 10 years longer than Mark Baby One of teenage conceptions. Will live 10 years less than Charles Aged 10 Enjoying a good life, lots of opportunity to play sport Aged 10 Growing up in poverty Aged 20 At university with 10 x A* at GCSE. Plays rugby and eats a healthy diet Aged 20 Left school with no qualifications, casual labourer, drinks, smokes and takes drugs Aged 45 Fit and healthy businessman, manages stress by playing squash Aged 45 Weighs 18 stone, has high cholesterol, type 2 diabetes Charles Mark Aged 60 Died from massive stroke Aged 60 Retired early to spend time with his grand- children and travel Source: NHS North West SHA 9

10 There are health inequalities within the West Midlands which are closely associated with deprivation and child poverty:  Deprivation: 27.4% of WM people live in 20% most deprived areas in England (England average 19.9%)  Child Poverty: 24.8% of WM children live in families receiving means-tested benefits (England average 22.4%) (Source: Health Profile 2010) Child Poverty 10

11 West Midlands Strategic Health Authority (Source: Health Profile 2010)

12 Large and escalating burden of disease not just from the public health perspective but also from an economic one Cardiovascular disease, diabetes, cancer and respiratory diseases Social burdens include –prolonged disability –diminished resources within families –reduced productivity –tremendous demands on health systems Source: UN High-Level Meeting on NCDs 23 September 2011 Costs 12

13 Smoking accounts for over 50% of health inequalities across different groups Direct Cost to NHS £5.2bn pa –Approx 5% of total NHS expenditure Healthcare costs for smokers up to 40% higher than for non-smokers Smoking in the West Midlands has decreased from 40% to 22% over 30 years, however challenges remain –Routine and manual workers –Pregnant women –Second hand smoke Smoking 13

14 Alcohol Alcohol related hospital admissions increased in the West Midlands - more than doubled in period 2002/3 to 2009/10 –46,616 to 113,205 Direct cost to NHS of alcohol harm reduction estimated at £1.7bn per year Costs to society, approx £20 bn per year 14

15 Source: NCHOD 2009 Equity from the Start 15

16 16

17 Infant Mortality – Key Actions Reduce smoking in pregnancy Reduce child poverty Increase breast feeding initiation Improve housing and reduce overcrowding Reduce obesity Reduce teenage pregnancy Reduce unexpected deaths in infancy Equity from the Start 17

18 Opportunities 18

19 19 Healthy Lives, Healthy People: our strategy for public health in England Aims to: empower local leadership to strengthen health and wellbeing support self esteem, increased confidence and personal responsibility promote healthier behaviour and lifestyles change the environment to support healthier choices protect the public from threats to health. December 2011: continuing to finalise key elements of the design of the new public health system Following extensive consultation, further details published in July 2011’s Update and Way Forward

20 20 Local Government’s “New” Functions New duty to improve the health of the population: some of most important levers for improving health and wellbeing - planning, transport, leisure, education - are instruments of local government health and wellbeing boards will integrate commissioning approaches (JSNA; JHWS) working with Clinical Commissioning Groups collaborating with the voluntary sector providing population healthcare advice to the NHS working with national bodies – PH England; NHS Commissioning Board Local political leadership critical to making this work and ensuring a ‘safe landing’ of public health functions.

21 “New” Duty to Ensure Plans in Place to Protect the Health of the Population Nothing new for local authorities - have had health protection responsibilities since the 19 th century and currently have major powers and responsibilities under existing legislation including Environmental Protection and Public Health Control of Diseases Acts Councils will have a new responsibility for ensuring adequate and appropriate health protection plans Most health protection incidents are contained locally The DPH will routinely assess intelligence on all incidents, and will lead the local response working with PHE and the NHS This will include outbreak management, infection prevention and control, and non-infectious environmental hazards System management still emerging

22 22 Local authority commissioning responsibilities: leadership role in tackling the causes of ill health; reducing health inequalities; promoting and protecting health; promoting social justice and safer communities * = mandated Tobacco control & smoking cessation Alcohol and drug misuse Services for children 5-19 National Child Measurement Programme* Obesity and weight management Local nutrition services Increasing physical activity NHS Health Checks* Public mental health services Dental public health services Injury prevention Birth defect prevention Behavioural and lifestyle campaigns to prevent LTCs Local initiatives on workplace health Support and challenge of NHS services (immunisation and screening) Public health advice to NHS* Sexual health services* Seasonal mortality initiatives Local role in health protection incidents* Community safety Social exclusion * Indicates mandated services


24 FAIR SOCIETY,HEALTHY LIVES CONCEPTUAL FRAMEWORK. REDUCE HEALTH INEQUALITIES AND IMPROVE HEALTH AND WELLBEING FOR ALL. Create an enabling society that maximises individual and community potential. Ensure social justice, health and sustainability are at heart of policies. A. Give every child the best start in life. C. Create fair employment and good work for all. B. Enable all children, young people and adults to maximise their capabilities and have control over their lives. D. Ensure healthy standard of living for all. E. Create and develop healthy and sustainable places and communities. F. Strengthen the role and impact of ill health prevention. EQUALITY AND HEALTH EQUITY IN ALL POLICIES. EFFECTIVE EVIDENCE BASED DELIVERY SYSTEMS Policy objectives Policy mechanisms

25 Principles Social justice Material, psychosocial, political empowerment Creating the conditions for people to have control of their lives Connects people, places and prospects

26 New approach to Public Health Protect and improve the public’s health, improving the health of the poorest fastest Reach Out and Reach Across – Address root causes and reach those who most need support Representative – Owned by communities and shaped by their needs Resourced – Ring-fenced funding and incentives to improve Rigorous – Professionally and politically led, evidenced, efficient and effective Resilient – Sustainability and protecting health 26 Source: Healthy Lives, Healthy People, Update and Way Forward, 2011

27 Deficit Process Disease Knowledge Medical Professional led Do to Asset Outcomes Wellbeing Action Social People led Do with Moving from the old to the new

28 Councillors as champions for their communities

29 Local Government Focus on needs of local population Capacity to orchestrate action to address the social determinants of health Whole system leadership Increasing participation and empowering communities in coproducing local issues and solutions Local democratic accountability

30 Opportunities for Councillors  Leadership and Advocacy for Improving health and Reducing Health Inequalities  Maximise opportunities for delivery of the new public health function and prevention services  Enable wider understanding of how all Local Authority portfolios can deliver improved health (housing, education, economy, regeneration, planning, social care, children’s services..)  Champion for improved public health through existing local government powers (e.g. using licensing in controlling cheap alcohol; fast food outlets)  Leadership on population behaviour change programmes (e.g. Change 4 Life; improved physical activity, increased walking and cycling for health, etc.)  Communicating with and in touch with local people (the power of social media)  Challenge poor outcomes through the Health and Wellbeing Board/Healthwatch/Scrutiny  Use of local health data and evidence base of what works with support from the Director of Public Health and service users through local Healthwatch  Develop new/strengthen existing local/national partnerships and alliances  Clinical Commissioning Groups  PH England  VCS

31 More Information? The new public health system factsheets are available at Sign-up to the national Transforming Public Health bulletin Contact the DH Public Health England transition team West Midlands PH Transition website West Midlands Councils 31

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