hertfordshire parish conference april 2014 public health
DESCRIPTION
The presentation for a plenary session with parish and town councils on their role in public health (followed by a workshop)TRANSCRIPT
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Jim McManus, OCDS, CPsychol, CSci, AFBPsS ,FFPH, FCIEH, FRSPH
Director of Public Health, Hertfordshire County Council
7thApril 2014, Hertfordshire Parish Conference
Parish and Town Councils: A Public Health role
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Some background reading for Public Health People on Parish and Town Councils
• NALC Website http://www.nalc.gov.uk/
• NALC guide http://www.townforum.org.uk/servicesstructure/parishcouncilguide2007.pdf
• Functions and powers of parish councils
• http://www.sstaffs.gov.uk/your_council/parish_councils/the_role_and_powers_of_parish_.aspx
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Some background Reading for Parishes• Hertfordshire public health strategy
http://www.hertspublichealth.co.uk/files/Healthier%20Herts%20Public%20Health%20Strategy%202013-2017.pdf
• District Councils Network public health pages http://districtcouncils.info/?s=public+health
• Public Health case study Hertfordshire http://www.local.gov.uk/documents/10180/11493/Hertfordshire+County+Council.pdf/31d6e952-d304-4cbc-b7e4-1f8f56d835af
• If I could do one thing...
• LGA http://www.local.gov.uk/web/guest/health-and-well-being-research/-/journal_content/56/10180/5945025/ARTICLE
• Herts County Council Public Health learning portal www.hertsdirect.org/phelearn
• Kings Fund guide to local authorities and public health http://www.kingsfund.org.uk/projects/improving-publics-health?gclid=COKssoyuzL0CFUTMtAodAwcAOg
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Three Questions
• How do you improve the health of your population?
– Connectedness, resilience, healthy living
• How do you protect the health of your population?
– Hazards and threats to health (eg crime prevention)
• What is it you can do that others cannot?
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Local government’s new public health functions
• commissioning a range of services from a range of providers from different sectors
• tackling the causes of ill-health & reducing health inequalities eg the way they operate the planning system
• promoting and protecting health
• promoting social justice and safer communities
• key partnerships with other agencies
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What is Public Health about then?• Health Protection
• Health Improvement
• Healthcare Public Health
• Reducing Health Inequalities..what do we mean by that?
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What about the way PH works?
• Basic science is Epidemiology – Who gets What and Where and When and How!
• Foundation stones are– Assessing population need
– Using evidence of what works
– The social determinants of health are paramount
– Prevention is better than cure
– Many outcomes can only be achieved by working with others
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Contributors to overall health outcomes and why elected councillors are important leaders
Smoking 10%
Diet/Exercise 10%
Alcohol use 5%Poor sexual health
5%
Health Behaviours 30%
Education 10%
Employment 10%
Income 10%
Family/Social Support 5%Community Safety 5%
Socioeconomic Factors 40%
Access to care 10%
Quality of care 10%
Clinical Care 20%
Environmental Quality 5%
Built Environment 5%
Built Environment 10%
Source: Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute. Used in US to rank counties by health status
While this is from a US context it does have significant resonance with UK Evidence, though I would want to increase the contribution of housing to health outcomes from a UK perspective.
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Phasing and Layering....
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The Lifecourse
• Phasing across the lifecourse and timeWorking age
AccumulationOf risk inLate workingage
Good early Years outcomesFor lifetimeMental health
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Layering across our lived realities
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Healthier Herts: A Public Health Strategy for Hertfordshire
OUR PURPOSEto work together to improve the health and wellbeing of the people of
Hertfordshire, based on best practice and best evidence
OUR VISION:A Healthy, Happy Hertfordshire: everyone in Hertfordshire is born healthy, and lives full, healthy and happy lives. We compare well with England and every area in Hertfordshire compares well
against Hertfordshire
Priority 5: We understand what’s needed and we do what works
Priority 6: We make public health everybody’s business and work together
HOW WE WILL WORK TOGETHER(our strategic priorities: how we do it for
our County)
ThePublicHealthOutcomesFramework(the nationalPHOF willHelp us measureOur success)
WHAT WE WILL ACHIEVE WORKING FOR AND WITH OUR RESIDENTS
(our strategic priorities: what we achieve for our County)
Priority 1: Our residents live Longer, Healthier Lives
Priority 2: Our residents Starts Life Healthy and Stays Healthy
Priority 3: We narrow the gap in life expectancy and health between most and least healthy
Priority 4: We protect our communities from harm (chemical, biological, radiological and environmental)
BuildingBlocks For the Public Health Family
Strong Leadership
Capable, Skilled People
Co-production with citizens
Effective Partnerships
Evidence and Knowledge Driven
Plan and Deliver for Localism
Whole System Approaches
Making better use of behavioural sciences at individual, interpersonal, community and service levels
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Back to the Three Questions
• How do you improve the health of your population?
– Connectedness, resilience, healthy living
• How do you protect the health of your population?
– Hazards and threats to health (eg crime prevention)
• What is it you can do that others cannot?
www.hertsdirect.org
Using Obesity as an Example
• What can we do about Obesity?
• It’s not just about exercise
• And it certainly isn’t just about education or willpower
• What’s the parish role?
• Think through public health challenges to arrive at parish roles
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Systems thinking on wider determinantsGetting everyone on the same systems page
The wider determinants of Health and Local Government functions (Must adopt a Lifecourse approach!) – obesogenic environment
The Lives people lead and whether LA functions help or hinder healthy lifestyles (policy, service quality, access, behavioural economics, behavioural sciences) – obesogenic context and community, obesogenic lifestyle
The services people access such as primary care (high quality, easy access, good follow up, behavioural and lifestyle pathways wrap around) – do services help or hinder?
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Average BMI
Underweight
Healthy weight
Overweight
Obese
Average BMI
Underweight
Healthy weight
Overweight
Obese
Fewer overweight Fewer obese
Reduce average BMI
Fewer underweight
Maximise proportion at a healthy weight
Minimise proportion at an unhealthy
weight
a new approach is needed, focus on shifting weight distribution in the population
Make more people a healthy weight, not just fewer people obese
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Some Answers
• How do you address obesity in your parish?
– Making healthy eating easy and second nature• The public realm, the shops, social opportunities,
– Making self-propelled transport and physical activity second nature , safe and easy• The public realm, the social environment, amenities
• Work across your planning,amenity, provision and other powers and duties
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15 Actions on Obesity so far (more will be done)
1. New weight management service already commissioned and reached 1st 1,000 referrals in three months, more will be commissioned
2. Obesity pathway in place for tiers 1 -3 obesity care. Revision late 2014
3. New lifestyle partnership launched with lifestyle offer for Herts residents to be ready by Easter for phased roll out
4. New online lifestyle service launched in February
5. Workplace physical activity challenge funded and running (Herts Sports Partnership)
6. Workplace Health improvement programme running (Business in the Community)
7. 93% of GPs in Herts now doing NHS HealthChecks
1. Obesity Plan approval by Cabinet due March 2014
2. New child weight management service to be commissioned in 2014
3. Broxbourne whole area obesity pilot underway with Borough and County Council, schools and NHS
4. Fast food takeaway restrictions
5. Countryside walks scheme
6. Year of Cycling launching May 2014
7. Funding for District Councils to work on health improvement agreed and each District working out its plans
8. Continue child weight measurement programme
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Some shared goals forPartnership Working
• the best start in life
• healthy schools and pupils
• helping people find good jobs and stay in work
• active and safe travel
• warmer and safer homes
• access to green and open spaces and the role of leisure services
• strong communities, wellbeing and resilience
• public protection and regulatory services (including takeaway/fast food, air pollution, and fire safety)
• health and spatial planning.
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Some enablers we need to work on together
• Data and JSNA• Working with Districts, Boroughs and County
• Workforce Development and learning www.hertsdirect.org/phelearn
• Communication and Strategy• Delivery Partnerships• Technical Advice and assistance/liasion• Health Protection Arrangements
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PrimaryPrevention
SecondaryPrevention
TertiaryPrevention
The shift to prevention
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Thank you!
Public Health page
http://www.hertsdirect.org/your-council/hcc/publichealth/
Free learning resources for public health
www.hertsdirect.org.uk/phelearn