Tackling Inequalities in Aberdeenshire Aberdeenshire Community Planning Executive, 26 th August 2015 George Howie Principal Health Improvement Officer Aberdeenshire Council/NHS Grampian Annette Johnston Tackling Poverty & Inequalities Aberdeenshire Council

Tackling inequalities – the national context Substantial inequalities in outcomes between communities across Scotland. The variation within each community planning area is greater than the average variation between community planning areas. Positive and negative life outcomes are highly clustered at neighbourhood level. Very negative outcomes in one aspect of life (e.g. health) is strongly linked with negative outcomes in all other aspects of life. Inequalities account for a significant element of the increasing demands on public services. The Christie Commission report suggested that around 40% of our spending is currently accounted for by interventions that could have been avoided by prioritising a preventive approach. The National Performance Framework “Scotland Performs” includes the outcome “We have tackled the significant inequalities in Scottish society”.

Tackling inequalities – the role of Community Planning Partnerships The National Community Planning Group have agreed that Community Planning Boards need to place “particular emphasis on preventing negative outcomes and reducing inequalities”. The Community Empowerment Bill states “a community planning partnership must act with a view to reducing inequalities of outcome which result from socio-economic disadvantage”. Three linked policy frameworks: Equally Well; the Early Years Framework; and Achieving Our Potential: a framework to tackle poverty and income inequality in Scotland. The Equally Well review confirmed “that the three social policy frameworks remain the best approach to deliver long term improvements in outcomes for people” with a need for “CPPs delivering genuinely integrated services, through partnership working and shared resources, which target the underlying causes of inequalities”.

Inequalities in Aberdeenshire Aberdeenshire contains five datazones that make up Scotland’s 15% most deprived datazones – two of these are in Banff and Buchan, in Fraserburgh and three are in Buchan, in Peterhead. Life expectancy across Aberdeenshire is amongst the highest in Scotland. Across Banff & Buchan, the life expectancy of the majority of communities is above the Scottish average, however, parts of Fraserburgh have significantly lower life expectancy for both males and females and increased mortality rates. Child poverty estimates are higher in Banff & Buchan and Buchan than elsewhere in Aberdeenshire with approx. 20% of children estimated to be in poverty after housing costs. 38.3% of single parent families were out of work, with a proportion of children potentially start life in poverty.

Inequalities in Aberdeenshire Rates of smoking in pregnancy are 26.0% in the most deprived quintile in Aberdeenshire and 7.1% in the least deprived. Banff & Buchan has the largest proportion of benefit claimants across Aberdeenshire. Evidence suggests those reliant on benefits may be unable to work for health reasons rather than due to lack of employment opportunities. High estimates of fuel poverty in several parts of Aberdeenshire. Aberdeenshire perceived to be a safe or very safe place to live. However, residents in some areas believe that fear of crime has an impact on how they lead their lives. Residents report having witnessed or experienced a range of community safety issues including, public disorder, people taking illegal drugs, underage drinking, and youth disorder.

Tackling inequalities – what works? Clear emerging evidence and messages from a number of recent expert opinion reports on local action required to address inequalities including:-  Local action on health inequalities (Institute of Health Equity/Public Health England, 2014).  If you could do one thing… (The British Academy, 2014).  Best preventative investments for Scotland, NHS Health Scotland, 2014).  Health Inequalities, Inequality Briefing 1 (NHS Health Scotland, 2015). The above reports provide practical information that can be applied within a local context – key focus on the contribution of local government, supported by other partners.

Emerging evidence/expert opinion – key messages Strong consensus about the importance of tackling fundamental causes of inequalities, including upstream measures, addressing social, economic physical environments and through interventions focusing on vulnerable groups. Tackling inequalities requires a range of actions to undo the fundamental causes, prevent the harmful wider environmental influences and mitigate the negative impact on individuals. Greater intensity of provision for those with greatest needs within a universal framework.

Emerging evidence/expert opinion – priorities for action Early intervention - good quality parenting programmes; improving the home to school transition. Education - building children and young people’s resilience in schools; reducing the number of young people not in employment, education or training (NEET); adult learning services. Employment – employability and employment opportunities; improving workplace health. Ensuring a healthy living standard – adoption of the living wage. Healthy environment - fuel poverty and cold-home related problems; improving access to green spaces.

Strategic approach to tackling inequalities in Aberdeenshire Financial Inclusion Health Inequalities Employment & Skills

Progress in Aberdeenshire by the Community Planning Partnership The Tackling Poverty and Inequalities Strategy Group coordinates partnership working and manages Fairer Scotland funding on behalf of the CPP. The Aberdeenshire Health Inequalities leads the multi-agency approach to address health inequalities in Aberdeenshire. One of its functions is to establish a shared understanding of health inequalities across the CPP.

Some examples of action to address inequalities in Aberdeenshire Climate/Sustainability – Community owned energy company. Early Years/Child Poverty – Grow Well Choices Early Years. Education – Grow Well Choices, Young Carers. Employability – Reach Project, Community Benefit Clauses. Financial inclusion – Here for You Centre, SMART Project. Housing – Cold homes/fuel poverty. Leisure Services – BFit4U Pilot. Social Care – Fraserburgh Secret Garden. Transport – Buchan Community Transport Project (Dial a Bus). Vulnerable Groups – Gypsy/Traveller Community, Homeless, Working Poor.

What can Aberdeenshire Community Planning Partnership do? Provide strong leadership– political, corporate and professional. Communicate with communities to build aspiration, trust and action. Understand local populations – asset based approaches can identify community resources. Engagement in itself may not reduce inequalities. Take evidence-informed action. Aim for equity in all activities and long-term sustainability. Use a life course approach – a range of structures, organisations and factors impact on people at each stage of the life course. Aim to improve outcomes for everyone but with a greater focus on those facing the greatest need and worst outcomes. Evaluate and share learning to inform planning and service delivery.

Discussion What are the implications of the emerging evidence for Aberdeenshire Community Planning Partnership e.g. opportunity to bring SOA Lead Partnerships together to develop a more common understanding and approach to tackling inequalities? What are we doing well currently to tackle inequalities? Where do we need to place greater emphasis e.g. Child Poverty, Living Wage?