Why Rural Health Matters – Looking After the Next Generation Jane Randall-Smith Chief Executive, Institute of Rural Health Jig-So, 17th October 2011

Outline Introduction to the IRH Setting the scene The issues Things to think about

Institute of Rural Health The Institute of Rural Health (IRH): UK-wide academic charity Three main academic programme areas: – research and consultancy – education and training – policy analysis (including rural proofing) “working to inform, develop and promote the health and wellbeing of rural people and their communities.”

IRH Research: – Contributing to the evidence base Education: – Developing a workforce fit for purpose Policy: – Informing and promoting

Setting the scene…

Rural

Health IRH takes an interdisciplinary approach which reflects our belief in the WHO definition of health... “health is a state of complete physical, mental and social well- being and not merely the absence of disease or infirmity”.

Determinants of health and wellbeing Source: Barton, H. and Grant, M. (2006) A health map for the local human habitat. The Journal for the Royal Society for the Promotion of Health, 126 (6). pp

Health and wellbeing Influenced by: Employment Income Education Housing Access to the natural environment Access to services Community safety

The Issues

Deprivation The Welsh Index of Multiple Deprivation 2008 ranks specific small areas in Wales in terms of relative deprivation. In Ceredigion, none of the areas fall in the 10% most deprived areas in Wales and overall the majority of its areas are less deprived than the Wales average.

WIMD Domains

Child Index

Access to services – For children “Distance Decay” –The further a person is away from a service the less likely they are to use that service Service utilisation is not a proxy for need More marked in certain sectors Access is influenced by social and cultural factors not just physical aspects

What do we know Ceredigion as a whole does not show as “deprived” but there are – pockets of need and – hidden deprivation elsewhere Access to services is a huge issue Poverty of choice

Things to think about …

Tackling child poverty in a rural setting Addressing inequalities: – Acknowledging the “rural idyll” – Removing the “rural mask” Poverty affects life chances

The rural setting Data at county level doesn’t tell the whole story One rural town is one rural town Dispersed populations Hidden deprivation Hard to reach Understanding the culture and social context

Young people in Ceredigion % of young people 0-15 yrs old 14.9% (Pembrokeshire 18.5%, Wales 18.2%) % of young people 0-4 yrs old 4.3% (Pembrokeshire 5.5%, Wales 5.8%) And, Ceredigion has the highest life expectancy in Wales!

WHY rural health matters Wellbeing: – The early years are crucial (and the importance of pregnancy) – Holistic approach: including family and the community – Looking at prevention / promotion – Raise expectations

To make things happen: Small and dispersed population: services to users and users to services - Making the links Working together: Integrated working: building on team-working - within and between organisations Role of the third sector Caring communities – resilience

Thinking ‘outside the box’ -

Further information Institute of Rural Health T e