1. FIT FOR THE FUTURE Leading the way in health & care PREVENTION & EARLY INTERVENTION: EVIDENCE & PRACTICE Chair:Dave Dawes, Nurse First CIC Jessica Allen, UCL Institute of Health Equality Lyn Bacon, Nottingham CityCare Partnership Ivo Gormley, GoodGym #fitforthefuture @SocialEnt_UK

2. Dr Jessica Allen Deputy Director, UCL Institute of Health Equity Jessica.allen@ucl.ac.uk Intervening Early for health equity

3. Inequalities in health Related to socio-economic status (conditions of daily life) Result in persistent health inequalities

5. Intervening early before ill health sets early and intervening early in life –Saves lives –Effective –Cost effective

6. Inequalities and poor health are expensive Costs of doing nothing on health inequalities England approx £70 billion annually EU approx 1.3 trillion euros

7. A.Give every child the best start in life B.Enable all children, young people and adults to maximise their capabilities and have control over their lives C.Create fair employment and good work for all 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 Fair Society: Healthy Lives: 6 Policy Objectives

8. Intervening early in life Most effective Disrupt the accumulation of disadvantage which leads to shorter life

12. Per cent 5 year olds achieving ‘good development score’,* Birmingham LA, West Midlands & England *in personal, social and emotional development and communication, language and literacy Source: Department for Education %

13. Self reported health by education and social expenditures: 18 EU countries Net Total Social Expenditures in PPP's Source: Dahl & van der Wel, data from EU SILC 2005

14. Action on inequalities depends on: Political Leadership Sector Leadership –Evidence –Financial case –Delivery and implementation –Levers and accountabilities –Advocacy and persistence

15. LOCAL IMPACT: DH remit Local authorities –75% of local authorities have been significantly influenced by Marmot, evidence by their Health and Well- being Strategies and JSNAs (joint Strategic Needs Assessments) –We have worked directly with 40 plus local authorities

16. Health Inequalities legislation Legal duties to reduce health inequalities for the first time Platform for joining up health services, social care services and health-related services at local level

17. National government’s response to Marmot review Public Health White Paper accepted: the need to address the social determinants of health The life course approach the importance of the social gradient and approved the use of proportionate universalism

18. Social Value Act Act 2012 public bodies in England and Wales must consider: How what is being proposed to be procured might improve the economic, social and environmental well-being of the relevant area, and How, in conducting the process of procurement, it might act with a view to securing that improvement”

19. Thank you www.instituteofhealthequity.org

20. FIT FOR THE FUTURE Leading the way in health & care PREVENTION & EARLY INTERVENTION: EVIDENCE & PRACTICE Chair:Dave Dawes, Nurse First CIC Jessica Allen, UCL Institute of Health Equality Lyn Bacon, Nottingham CityCare Partnership Ivo Gormley, GoodGym #fitforthefuture @SocialEnt_UK

21. http://www.nottinghamcitycare.nhs.uk/small-steps-big- changes-funding-win/