Transcript Presentation for PHCs

• A Guide To Improving Health and
Reducing Inequalities in Aberdeenshire
2011-2015
Summary
•
The Guidance has been
developed to support Community
Planning Partners to tackle health
inequalities and, in this time of
financial pressure, target resource
to where the need is greatest.
Following extensive consultation
the guidance was endorsed in
June 2011.
•
The guidance is well linked with
the National and local strategic
context. It is especially focused on
those who are more vulnerable or
who have a higher risk of
preventable ill health.
Health Improvement is a National
and Local Priority
• The Scottish Government
recognises that addressing
inequalities in health is
fundamental to bringing about
health gain for the population.
• Improving Health and
Reducing Inequalities is a key
national priority and at a local
level is a strategic theme for
NHS Grampian.
• The Guide is complementary
to the Improving Health and
Wellbeing Framework of NHS
Grampian.
Health Improvement is everyone’s
business
•
Improving health and tackling
health inequalities is a big part of
the business of the NHS, but it is
not the only organisation which
has an impact or an interest in
improving health.
•
Community Planning Partnerships
(CPPs) in Local Authority areas
are required to develop a process
for planning effectively to deliver
on the health improvement and
tackling inequalities agenda.
•
With increasing financial
pressures it is important that
partners co-ordinate action to
target remaining resources on
local needs and priorities
Much progress has been achieved
• At a local level, NHS Grampian
and Aberdeenshire Council
have a long and fruitful history
of working together to improve
health and tackle inequalities.
•
Successful joint working to
improve health across
Aberdeenshire in recent years
includes the Early Years work
in Fraserburgh; the Buchan
Alcohol project and the Huntly
Community Kitchen.
Aberdeenshire Health
Improvement Priorities
• The priorities identified for
Aberdeenshire 2011-2015
match closely the health
improvement priorities
identified for Scotland.
• Reducing inequalities overarching priority
• Early years
• Mental health
• Tobacco
• Alcohol and other drugs
• Healthy eating active living
• Building capacity within
agencies and communities.
Health profile of Aberdeenshire
•
Overall the health profile for
Aberdeenshire is good.
Considering Aberdeenshire as a
whole, male life expectancy is the
second highest of all the
Community Health Partnerships
across Scotland and female life
expectancy is also significantly
better (higher) than average.
•
All-cause mortality (all ages), and
mortality rates from coronary heart
disease, cancer and
cerebrovascular disease (under75s), are all significantly better
(lower) than the Scotland average
•
Scotland’s Health - Inequalities
• Overall life expectancy remains low compared to
many European countries (75.3 years for males &
80.0 years for females)
• In 15% most deprived areas Health Life Expectancy
(HLE) is 57.5 years for men and 61.9 years for
women
• Premature mortality (under 75) declined from 507
per 100,000 (1995) to 383 per 100,000 (2008)
• CHD mortality fell by 39% overall, but only 32% in
deprived areas
• Cancer mortality fell by 11% in Scotland, but only 2%
in most deprived areas
Health Picture at a smaller level
•
The health picture is very different
when viewed at a smaller area
level. There are small areas of
deprivation in Aberdeenshire
where health outcomes are
significantly poorer than the rest of
Aberdeenshire and which are
within the worst 5-20% in
Scotland.
•
Notably health outcomes are
worse across North Aberdeenshire
(Buchan and Banff & Buchan
areas), in Huntly area and in parts
of South Aberdeenshire,
particularly the coastal strip south
of Stonehaven (measured by the
Scottish Index of Multiple
Deprivation 2009).
Health and Wellbing profiles
• ScotPHO ‘Health and
Wellbeing Profiles 2010’
present information on
indicators of health, wellbeing
and wider determinants, at
NHS Board, community health
partnership and local area
(intermediate zone geography)
level. e.g. low weight live
births, estimated smoking
prevalence; patients
hospitalised with alcohol
conditions; emergency
admissions to hospital. The
detailed reports are available
at
http://www.scotpho.org.uk/profi
les/
Rural deprivation and Isolation
• Access and transport- e.g.
high car dependency, difficulty
using pubic transport to access
hospital appointments
• Service provision-decline in
rural facilities- e.g. post
offices, banks, garages and
shops
• Affordable housing- e.g. low
levels of social housing
 Fuel poverty- e.g. increase in
fuel prices, inadequate heating
in houses
Rural deprivation and Isolation
• Employability- e.g. low
wage/working poor economy,
lots of seasonal employment,
part time opportunities and
high costs e.g. for getting to
work and child care
• Opportunities for young
people- e.g. limited
opportunity for housing and
employment leads to young
people moving away from rural
areas
Reducing Inequalities in Health
•
“Reducing health inequalities is a matter of fairness and social justice.
There is a social gradient in health – the lower a person’s social position,
the worse his or her health. Action on health inequalities requires action
across all the social determinants of health”. Marmot review 2010
(http://www.marmotreview.org).
•
‘Equally Well’, the report of the Ministerial Taskforce on health inequalities,
and subsequent implementation plan were published by the Scottish
Government in 2008 and included 78 recommendations to reduce
inequalities in healthy life expectancy and wellbeing. An Equally Well
Review document was published in 2010 .
•
Of these, 33 recommendations are applicable to the NHS and other
Community Planning Partners available online at:
http://www.scotland.gov.uk/Publications/2010/06/22170625/0
•
Action in Aberdeenshire to reduce
inequalities
• In Aberdeenshire action to
reduce inequalities in health
may be categorised into the
following priority areas of focus
on -:
• Identified geographic areas /
communities of deprivation
• Identified rural areas to
address access and other
identified needs
• Key vulnerable groups to
address health needs and
ensure equitable access to
services
• .
Action in Aberdeenshire towards
the Early Years agenda
• Action in Aberdeenshire
towards the Early Years
agenda includes implementing
UNICEF Baby Friendly
Initiative, providing training and
support to encourage
breastfeeding. Implementing
the Childsmile programme
across schools and nurseries
in Aberdeenshire to promote
and improve the oral health of
children. Implementing the
child healthy weight
programme to encourage
healthy eating/physical activity
and reduce levels of childhood
obesity
Action in Aberdeenshire towards
improving mental health
• Mental health is important to everyone as it affects every
aspect of our lives; there is no health without mental
health. Mental health improvement refers to
activity which promotes the mental wellbeing of the
general population, reduces the prevalence of common
mental health problems and improves the quality of life
for those with mental health problems or illness. Mental
health improvement is the responsibility of individuals,
communities and service providers. The Scottish
Government outlines its vision, policy and action plan
for mental health improvement in Towards a Mentally
Flourishing Scotland: Policy and Action Plan 2009-2011
available online at:
http://scotland.gov.uk/Publications/2009/05/06154655/0
Action in Aberdeenshire to reduce
the impact of tobacco
•
•
In Aberdeenshire smoking
prevalence rates have declined in
recent years, but still
approximately 20% of adults
reported to smoke in 2007/08, with
higher rates of 30-35% in deprived
areas.
Reducing the impact of tobacco in
terms of reducing smoking,
reducing the effects of smoking on
communities and preventing the
uptake of smoking is a key
national and local priority. In
Aberdeenshire a wide range of
work is ongoing to tackle tobacco
issues co-ordinated by
Aberdeenshire Local Tobacco
Alliance (ALTA) and NHS
Grampian.
Action in Aberdeenshire to address
the misuse of alcohol and other
drugs
• In Aberdeenshire a wide
range of work is ongoing
around alcohol and
substance misuse e.g.
The Alcohol and Drugs
Partnership (ADP) has
taken forward work
around community safety
and alcohol and drug
misuse, campaigns to
promote safer drinking
and a wide range of
public engagement
events.
Healthy Eating Active Living in
Aberdeenshire
• In Aberdeenshire a wide range
of work is ongoing to develop
foodskills, promote healthy
eating and increase physical
activity levels e.g. Huntly
Community Kitchen; Active
Aberdeenshire campaign
www.ouractivenation.co.uk;
The Eat Play and Grow Well
intervention targeted at
children who are outwith the
healthy weight range; Training
health and wellbeing leaders in
schools at both pupil and staff
levels to lead health
improvement in schools.
Building Capacity
•
•
•
In Aberdeenshire a wide range of
initiatives have been undertaken
to build capacity and develop a
strategic, co-ordinated and
consistent approach to health
improvement activity across
Aberdeenshire, e.g.:
Integrated Impact assessment
(IIA) piloting a screening tool to
assess the impact of council
services, policies, plans and
strategies on equalities, health,
the environment and socio
economic issues.
Health Improvement workshops
held with Local Community
Planning Groups (LCPGS) and
Area Committees.
Building Capacity in Communities
•
A community led approach to health improvement is concerned with supporting disadvantaged
communities to identify and define what is important to them about their health and wellbeing and
take the lead in identifying and implementing solutions. Similarly an asset approach is about
identifying communities’ collective strengths, resources, capacities and skills to improve health
outcomes. It’s about recognising and understanding a communities concerns, values and
priorities. In Aberdeenshire a wide range of initiatives have been undertaken to develop a
community led or asset approach to health improvement, e.g.
•
Huntly Community kitchen was developed with Community Planning Partners and Huntly Health
project. The kitchen was established with the involvement, ownership and direction of local people
and groups. People of all ages make use of the kitchen from young mums to older people. Local
research indicates that 40-50 groups are using the kitchen to support improved eating habits for
vulnerable individual and groups. The kitchen works using an integrated approach for example
links with the community allotment scheme allow participants to look at growing food, links to
community reading schemes allow participants to use recipes to support literacy. In addition to
cooking and nutrition the kitchen acts as a resource for local people, for example, the active
schools co-coordinator and outdoor trust provided a programme of cooking/gardening and outdoor
events for P5/6 pupils for a term.
•
Targets and Perfomance
Monitoring
•
Aberdeenshire Health Improvement Group (HIG) is the main multiagency health improvement group in Aberdeenshire where
performance monitoring takes place. Reports are also submitted to
the Aberdeenshire CHP Committee, to NHS Grampian and to
Aberdeenshire and Grampian wide partnerships.
• Aberdeenshire Single Outcome Agreement (SOA) identifies high
level joint outcomes for the Community Planning Partnership (CPP).
These high level outcomes are supported by more detailed multi
agency planning at operational level.
• Community Wellbeing is one of five key themes of the CPP.
Priorities and examples of action to achieve a Healthier
Aberdeenshire are detailed in the Community Plan available on line
at: http://www.aberdeenshire.gov.uk/communityplanning/index.asp