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Part 1Part 1

Presented by Mavis Ames Presented by Mavis Ames

Portsmouth City CouncilPortsmouth City Council

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Healthy Eating, exercise and Healthy Eating, exercise and dental health programmedental health programme

Commissioned by the local Strategic Commissioned by the local Strategic Partnership.Partnership.

Targeting children, young people and Targeting children, young people and their families in areas of high their families in areas of high deprivation.deprivation.

Funded by Neighbourhood Renewal Funded by Neighbourhood Renewal fund and Single Regeneration Budget.fund and Single Regeneration Budget.

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Focus AreasFocus Areas

Healthy Eating.Healthy Eating. Access to Healthy Foods.Access to Healthy Foods. Dental Health.Dental Health. exerciseexercise

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PARTNERS IN THE HEALTHY EATING PROJECT

PortsmouthFood andHealthGroup

SureStart

PCCStrategy

Communitygrowingprojects

PortsmouthHospitals Portsmouth

University

PortsmouthPCT

LeisureServices

HealthDevelopment

Team

Dot-to-dotCommunityArts Project

Community

VOLUNTARYSECTOR

SocialServicesChildren’s

Trust

LLooccaallBBuussiinneessss

PortsmouthPartnership

HealthySchools

Libraryservices

Regenerationteam

EDUCATION

LSPHHEEAALLTTHHYYEEAATTIINNGGPPRROOJJ EECCTT

PortsmouthFC

ChichesterFestivalTheatre

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Involvement from the Involvement from the communitycommunity

Each area has a local health group to own Each area has a local health group to own the process and give directions to the the process and give directions to the work.work.

Local people involved in the recruitment Local people involved in the recruitment and selection of care staff.and selection of care staff.

Local people trained and recruited to work Local people trained and recruited to work as ‘community champions’.as ‘community champions’.

Parents trained to set up and support Parents trained to set up and support breakfast clubs.breakfast clubs.

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Involvement from the Involvement from the communitycommunity

Children and young people central to the Children and young people central to the whole process for examplewhole process for example

(1) slogan and logo competition(1) slogan and logo competition

(2) animation video(2) animation video

(3) collecting baseline data for breakfast(3) collecting baseline data for breakfast

clubclub

(4) interviewing for school meals (4) interviewing for school meals providersproviders

and breakfast cluband breakfast club

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Value of community Value of community approachapproach

Development of women in Health Development of women in Health Group.Group.

Expansion of Healthy Walks.Expansion of Healthy Walks. Support and encouragement from Support and encouragement from

the community.the community. Developments of skills and Developments of skills and

confidence.confidence.

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Future WorkFuture Work

Joint initiative with Portsmouth football Joint initiative with Portsmouth football club.club.

Arts project - school dining areas.Arts project - school dining areas. Possible social enterprise project around Possible social enterprise project around

food delivery.food delivery. Nutrition training for professionals.Nutrition training for professionals. Allotment for the Bangladeshi Allotment for the Bangladeshi

communitycommunity

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What nextWhat next

Mid term evaluation currently Mid term evaluation currently being carried out.being carried out.

Sustainability audit.Sustainability audit. Action Planning for year 2.Action Planning for year 2.

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Part 2Part 2

Presented by Nick Bishop Presented by Nick Bishop

Portsmouth City CouncilPortsmouth City Council

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So why is it so important to So why is it so important to engage people from the engage people from the

communities in the delivery communities in the delivery of this project?of this project?

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In order to fully appreciate this I In order to fully appreciate this I needneed

to let you have a little background to let you have a little background onon

health inequalities in Portsmouth.health inequalities in Portsmouth.

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Poorer people get sick more often Poorer people get sick more often andand

die earlier. Social circumstances anddie earlier. Social circumstances and

the effects of childhood poverty arethe effects of childhood poverty are

linked to overall health and life linked to overall health and life expectancy.expectancy.

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Social inequality breeds health Social inequality breeds health inequality and is passed down frominequality and is passed down from

generation to generation.generation to generation.

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In Portsmouth this means a In Portsmouth this means a difference in life expectancy of up difference in life expectancy of up to 8 years from one area to to 8 years from one area to another within a radius of 5 miles. another within a radius of 5 miles.

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But surely all that we need to do to tackleBut surely all that we need to do to tackle

these inequalities is to run some hard-these inequalities is to run some hard-

hitting campaigns in the inner city, tellinghitting campaigns in the inner city, telling

people that they need to:people that they need to: Smoke lessSmoke less Drink lessDrink less Exercise moreExercise more Relax moreRelax more

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Problem solved then? Not quite.Problem solved then? Not quite.

The reality:The reality: Excessive drinkingExcessive drinking SmokingSmoking Lack of exerciseLack of exercise StressStress Are inextricably linked to social Are inextricably linked to social

circumstances, childhood poverty, access to circumstances, childhood poverty, access to services, housing conditions, income, services, housing conditions, income, gender etc. gender etc.

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Unless we tackle the underlying Unless we tackle the underlying causes of health inequalities, we causes of health inequalities, we will never break the cycle and will will never break the cycle and will continue to have people in the continue to have people in the same city with such unacceptable same city with such unacceptable differences in terms of life differences in terms of life expectation. expectation.

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So what does this have to do with obesity andSo what does this have to do with obesity and

dental health?dental health?

Doesn’t obesity affect everyone, rich and Doesn’t obesity affect everyone, rich and poor?poor?

To a certain extent this is true, but there is aTo a certain extent this is true, but there is a

very strong evidence to suggest that levels ofvery strong evidence to suggest that levels of

obesity and certainly poor dental health are farobesity and certainly poor dental health are far

higher in areas that historically suffer fromhigher in areas that historically suffer from

health inequalities.health inequalities.

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Poor diet for example can very clearly bePoor diet for example can very clearly be

linked to the affordability and lack oflinked to the affordability and lack of

access to fresh fruit and vegetables or aaccess to fresh fruit and vegetables or a

lack of knowledge about what is a goodlack of knowledge about what is a good

diet and skills in basic food preparation.diet and skills in basic food preparation.

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A lack of exercise can again, in A lack of exercise can again, in manymany

cases, be directly linked to cases, be directly linked to accessibilityaccessibility

and affordability, and a basic lack ofand affordability, and a basic lack of

knowledge relating to the health knowledge relating to the health benefits. benefits.

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Similarly, with dental health the Similarly, with dental health the picturepicture

in the inner city area is far worse than in the inner city area is far worse than inin

other areas of the city, and in many other areas of the city, and in many cases the national average and in one cases the national average and in one school over 90% of the children have school over 90% of the children have at least some decay.at least some decay.

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So how do we address the problem? So how do we address the problem?

Another hard-hitting campaign tellingAnother hard-hitting campaign telling

children and parents of the need to:children and parents of the need to: Eat more fruit and vegetables and Eat more fruit and vegetables and

less fatty food.less fatty food. Exercise more.Exercise more. Look after their teeth.Look after their teeth.

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That should do the trick and bring about hugeThat should do the trick and bring about huge

improvement.improvement.

Wrong again, I’m afraid.Wrong again, I’m afraid.

Health promotion campaigns, howeverHealth promotion campaigns, however

““hard hitting” have achieved very little in hard hitting” have achieved very little in terms of long term change in areas with terms of long term change in areas with above averageabove average levels of health inequalities levels of health inequalities that are linked to social circumstances and that are linked to social circumstances and poverty.poverty.

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Unless we tackle the underlyingUnless we tackle the underlying

determinants of health inequalities determinants of health inequalities at the same time as tackling the at the same time as tackling the inequalitiesinequalities

themselves, we will never break the themselves, we will never break the cycle.cycle.

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So how do we change things?So how do we change things?

There is a growing recognition of the There is a growing recognition of the unacceptability of health inequalities. unacceptability of health inequalities.

National targets are now being set inNational targets are now being set in

relation to obesity and exercise. And relation to obesity and exercise. And attempts are being made to look at attempts are being made to look at the fat and salt content of school the fat and salt content of school mealsmeals

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Very good but tackling health Very good but tackling health inequalitiesinequalities

such as these, also requires giving such as these, also requires giving those who have responsibility for those who have responsibility for development at grass roots level, the development at grass roots level, the freedom locally to decide how to do freedom locally to decide how to do it.it.

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The only way to bring about really sustainableThe only way to bring about really sustainable

change and improvement is to engage localchange and improvement is to engage local

people in the identification of local need and people in the identification of local need and

in the planning, delivery and monitoring ofin the planning, delivery and monitoring of

services. services.

We have to see people as part of the solutionWe have to see people as part of the solution

rather than as the problem.rather than as the problem.

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This is what the Healthy Eating, This is what the Healthy Eating, ExerciseExercise

and Dental Health project has done; and Dental Health project has done; itit

has, from the outset been has, from the outset been community ledcommunity led

and community owned.and community owned.

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Local people have been engaged Local people have been engaged and empowered to work in and empowered to work in partnership with the local partnership with the local authority, PCT and others and they authority, PCT and others and they have had a real role in developing have had a real role in developing the overall project, setting the the overall project, setting the priorities and monitoring the priorities and monitoring the outcomes outcomes