UKPHR Consultative Forum 5 th November 2015 Dr Anne Kilgallen

Welcome to Northern Ireland

This morning I shall discuss.... The Major Public Health Challenges Facing the People of Northern Ireland Our strategies to improve health Brief reflections on implications for workforce development and capacity building

Dr Samuel Browne

Health Challenges for NI Demographic – ageing population - growth in chronic conditions Higher rates of preventable illness and premature deaths in most deprived areas Correlations with wider determinants such as educational attainment “At risk”/vulnerable groups

Life expectancy in Northern Ireland

Life expectancy by Deprivation Northern Ireland 2008 ‐ 10

Life expectancy at selected points along a Belfast Metro bus line ( )

Health Inequalities - General Average male life expectancy is now 77.5 years (2009/11), and female life expectancy is 82.0 In the same period the gender gap in life expectancy has decreased by 2 years to 4.4 years Coronary heart disease, cancer and respiratory disease continue to be the main causes of death for both sexes There is a notable increase in death rates from cancer, CHD and respiratory disease as level of deprivation increases Health surveys show that respondents in more deprived areas are less likely to meet the lifestyle choice recommendations when compared with those in less deprived areas

Smoking prevalence

Smoking and health inequalities

Prevalence of Obesity Health Survey Northern Ireland (HSNI) 2013/14 Adults - 61% of adults were either overweight (37%) or obese (24%). Children - These findings use International Obesity Task Force (IOTF) cut-off points of the BMI percentiles for children aged 2-15 years of age. 17% of children aged 2-15 were classed as overweight and 7% were classed as obese.

Obesogenic Environment Overweight and Obesity and other risk factors Increased risk of associated health conditions:  Type II Diabetes  Heart disease/stroke Physical inactivity and unhealthy eating (and other risk factors) Individual Factors  Knowledge  Skills and habits  Attitudes  Psychological factors Social Factors  Educational level  Socioeconomic status – poverty, health inequalities Environmental Factors Affecting the behaviour of the individual  Portion sizes  Ready Access (vending machines)  Physical activity opportunities (green spaces)  Occupational inactivity Immutable factors  sex  age  genetics

Trends in diagnoses made in Northern Ireland GUM Clinics,

Table 2: New diagnoses of HIV and AIDS in Northern Ireland, by year of diagnosis, and deaths in HIV-infected individuals, by year of death

Alcohol related hospital admissions by deprivation

% Difference from the NI average Suicide rate by economic deprivation

WIDER DETERMINANTS More than 1 in 5 children growing up below the poverty line 42% of households in fuel poverty Unemployment rate 6.0 %: –Rate for yr olds 28% –Long Term unemployed 59% of the total unemployed

A WHOLE SYSTEM STRATEGIC FRAMEWORK FOR PUBLIC HEALTH

Vision and Aims All people are enabled and supported in achieving their full health and wellbeing potential. The aims are to achieve better health and wellbeing for everyone and reduce inequalities in health.

Key Features High level/strategic/cross – cutting Collaboration, engagement and empowerment Thematic approach - wider determinants and lifecourse Outcomes and supporting actions The social gradient – proportionate universalism Whole system approach

Values Social justice, equity and inclusion Engagement and Empowerment Collaboration Evidence informed Addressing local need

Making Life Better - Themes Giving Every Child the Best Start Equipped throughout Life Empowering Healthy Living Creating the Conditions Empowering Communities Developing Collaboration

Making it Work

Challenges for The Public Health Function Ensuring we have the capacity to meet our public health challenges across the three domains. Ensuring we continue to have a highly skilled specialist workforce to meet our needs Ensuring we develop specialists from disciplines other than medicine

Challenges for the Public Health Function Ensuring closer working across the devolved administrations and Ireland Developing our wider public health workforce within the HSC and beyond

Thank You