Improving Health through Healthy Schools

Cathy WynneRegional Public Health Specialist NW

DHSC North

Lancashire Healthy Schools Programme Launch April 2002

Saving lives: Our Healthier NationThe Goals

Improve health

To improve the health of the population as a whole by increasing the length of people’s lives and the number of years people spend free from illness

Narrow the health gap

To improve the health of the worst off in society and to narrow the health gap

The role of education

‘ Education is vital to health. People with low levels of educational achievement are more likely to have poor health as adults…By improving education for all we will tackle one of the main causes of inequality in health’

(Department of Health 1999, Saving Lives Our Healthier Nation)

The widening health gapDeath ratios by social class

Social class

Professional

Unskilled

Average for working age men

Year1930-32 1959-63 1991-93

Log scale160

100

50

25

1.2 times greater

2.9timesgreater

England & Wales

Inequality: social classExcess death rates for men in non-professional classes

England & Wales 1991-93

280

300

426

493

492

806

I - Professional

II - Managerial

IIIN - Skilled (non-manual)

IIIM - Skilled (manual)

IV - Partly Skilled

V - Unskilled

European standardized mortality ratio per 100,000 population for men aged 20 - 64

Inequalities in healthy life expectancy

• 17% of social class 1 men aged 45 - 64 report limiting longstanding illness

• 48% of social class 5 men aged 45-64 report limiting longstanding illness

Health inequalities:geographical variations

• A boy in Manchester can expect to live over 7 years less than a boy in Barnet

• A girl in Manchester can expect to live 6 years less than a girl in Kensington, Chelsea and Westminster

Health inequalities:Six priority areas for action

• Providing a sure foundation through a healthy pregnancy and early childhood

• Improving opportunity for children and young people

• Tackling the major killers – CHD and cancer• Strengthening disadvantaged communities• Tackling the wider determinants of health• Improving NHS Primary Care Services

What is health?

WHO defines health as

“ a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity”

Health Determinants

Mortality TrendsEngland and Wales 1841 - 1985

World Bank Review1993

Health Care Spending and Population Health Status

• “At any level of (population) income and education, higher health spending should yield better health, all else being equal. But there is no evidence of such a relation” World Bank Investment for Health Report (1993)

Causes of Premature Death & Disability

(and thus health sector costs)

• 10% due to inadequate access to health care

• 20% genetic

• 20% environmental

• 50% behavioural & lifestyle US Surgeon General (1996)

Health Promotion is the process of enabling people to increase control over and improve their health.

Health Promotion is about making healthy choices the easy choices

“Health is created and lived by people within the settings of their everyday life: where they learn, work, play and love.”

Ottawa charter, WHO, 1986

Health promoting settings

• Healthy schools

• Healthy workplaces

• Healthy prisons

• Healthy hospitals

• Healthy colleges

• Healthy ………..

Addressing the determinants of health

in 1866

“Building more children's hospitals is not the proper remedy for infantile mortality and sickness - the true remedy lies in improving children's homes”

In 1866 Florence Nightingale was asked to open the new children's hospital in Manchester.

Brierly JK (1970) A Natural History of Man. Heinemann

Health promotion IN a setting

• Problem-specific focus

• External or ‘internal-specialist’ impetus

• Lack of impact on the organisation as a whole

3 elements of a health-promoting setting

• Creating a healthy living and working environment for clients and staff

• Integrating health promotion and health education into the daily activities

• Outreach into the community

A health-promoting setting

• Becomes engaged in an ongoing process of reviewing its activities and functions in relation to their health impact

• Is committed to integrating health issues into its routine structures and functions to create an environment conducive to health

Healthy Schools – who benefits?

• Students

• Staff

• Parents

• Community

Healthy Schools support…..

• Safer routes to school• Fruit in schools• 5 a day• Smoking policy• Schools Nutrition Action• Circle time• Emotional literacy• Staff support

Why Healthy Schools?

• Reach whole population

• Staff/parents/students/community

• Address inequalities

• Influence behaviour/lifestyle

• ‘Virtuous circle’

Healthier children more ready to

learn

Education improves life-chances and

thereby health

Win – Win for education and health

– and for children!

Improving Health through Healthy Schools

Cathy WynneRegional Public Health Specialist NW

DHSC North

Lancashire Healthy Schools Programme Launch April 2002