1. Improving health & wellbeing & reducing health inequalities in Fife Fife Health & Wellbeing Alliance

2. Reducing Health Inequalities Health varies in Fife in relation to Socio-economic status Gender Ethnicity Place of residence Other inequalities

3. Influences on Health

4. All cause mortality rate per 100000 population aged under 65, by interzone, Fife and Scotland, 2006 Fife Scotland Interzone

5. Percentage of women smoking in pregnancy by interzone, Fife and Scotland, 2005-07 Fife Scotland

6. Percentage of S4 children attaining English and Maths at SCQF level 3 and above, 2006 Looked after children40% Fife89% Scotland91.3% Risk factors for teenage pregnancy Poor attendance rates and dislike of school Poor educational attainment

7. Reducing health inequalities What works? Environment/legislation/regulation/ fiscal policies Income support/reducing price barriers Improving accessibility of services Prioritising disadvantaged groups Starting young/offering intensive support

8. FHWA Children’s Services Group Sustainable Communities Group Health & Social Care Partnership Fife Housing Partnership DAAT

9. Improving Health & Wellbeing Well-being Population health Health inequalities Individual behaviours Economic, and physical environments LONG-TERM HIGH LEVEL OUTCOMES INTERMEDIATE OUTCOMES SHORT-TERM OUTCOMES Outputs Inputs Processes Performance management SOA Community Plan JHIP Outcome Indicators Outcomes related to JHIP focus areas HIF & FSF Agreements

10. INDICATORS Current State Trend OUTCOME: REDUCED HEALTH INEQUALITIES All cause mortality under 65 years rate per 100,000 population in 20% most deprived areas compared to 20% least deprived areas in Fife  Smoking in pregnancy in 20% most deprived areas compared to 20% least deprived areas in Fife  Low birth weight babies in 20% most deprived areas compared to 20% least deprived areas in Fife  All cause mortality under 75 per 100,000 population in regeneration areas compared to Fife  Cancer mortality under 75 rate per 100,000 population in regeneration areas compared to Fife  Coronary heart disease mortality under 75 rate per 100,000 population in regeneration areas compared to Fife 

11. OUTCOME: HEALTHIER ENVIRONMENTS AND COMMUNITY WELLBEING Current State Trend % of Council-owned homes meeting Scottish Housing Quality Standard  Annual number of affordable housing units delivered through government subsidy  Annual number of affordable housing units delivered through private sector N/A % of Fife residents rating their area as a very good or fairly good place to live  Young people and alcohol  Reducing Heroin use in under 20s  Older people receiving intensive care at home as a % of older people receiving long term care at home or in a care home 

12. OUTCOME: HEALTHIER LIFESTYLES Breastfeeding  Teenage pregnancy  Young people and physical activity  Young smokers  Hospital admission rates for coronary heart disease  Hospital admission rates for respiratory disease  Cancer registrations  Fruit and vegetable consumption  Food poisoning notifications  Physical activity 

13. Clear Leadership on health inequalities Links across partnerships and agencies Influencing how/where services are delivered Issues

14. Implementing/monitoring JHIP activity Local service delivery Evaluation Learning from what works Targeting activity Developing better measures Issues

15. Influencing policy & organisational culture Different drivers & priorities Links & collaboration Issues