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Public Health in Yorkshire and the Humber Stephen Morton, Centre Director, Yorkshire and the Humber Our mission Our mission is to protect and improve the nation’s health and to address inequalities, working with national and local government, the NHS, industry, academia, the public and the voluntary and community sector. What we want to be known for We want to be known for encouraging evidence-led action with scale and pace to make a significant and sustainable improvement to the public’s health Our Priorities 1. Helping people to live longer and more healthy lives by reducing preventable deaths and the burden of ill health associated with smoking, high blood pressure, obesity, poor diet, poor mental health, insufficient exercise, and alcohol 2. Reducing the burden of disease and disability in life by focusing on preventing and recovering from the conditions with the greatest impact, including dementia, anxiety, depression and drug dependency 3. Protecting the country from infectious diseases and environmental hazards, including the growing problem of infections that resist treatment with antibiotics 4. Supporting families to give children and young people the best start in life, through working with health visiting and school nursing, family nurse partnerships and the Troubled Families programme 5. Improving health in the workplace by encouraging employers to support their staff, and those moving into and out of the workforce, to lead healthier lives Our Priorities To underpin these outcome-focused priorities we will: 6. Promote the development of place-based public health systems 7. Develop our own capacity and capability to provide professional, scientific and delivery expertise to our partners The national public health system The Department of Health will set the legal and policy framework, secure resources and make sure public health is central to the Government’s priorities. Executive Agency Section 7A Agreement Public Health England The PHE-NHSCB Partnership Agreement Chief Medical Officer The local and regional presence 8 Knowledge and Intelligence Hubs • • • • • • • • London South West South East West Midlands East Midlands North West Yorkshire and Humber North East Other local presence • • • Ten microbiology laboratories Field epidemiology teams Centre for Radiation Control units Sources of public health advice in the ‘Place-based’ approach to local public health 3rd sector providers People and communities NHS & IS Providers Health and wellbeing boards PHE centre Public health advice Local government CCGs & their support NHSCB area team Commissioner of public health services Leverage from the public health ringfence Influence on wider spending in commercial and voluntary sectors DsPH have influence across all local government spend PHE provides expert advice to local government PHE provides expertise in local area teams Clinical Commissioning Groups and Embedding ‘making every contact count’ Centres for Public Health England: The One-Stop Shop The PHE Centre is a full partner in the local public health system whose unique role is to provide an agreed range of services and expert advice that is tailored to meet the local needs, wishes and aspirations of local government and the local NHS. The Centre is the “front-door” of PHE – it is not the only route through which PHE will work with local partners but it is responsible for assuring that services provided by PHE to the locality are agreed and meet local needs. Can PH action reduce inequality? 50 absolute gap in <75 standardised mortality 45 40 CVD Mortality <75 Gaps for former Spearhead* authorities relative to the England averages: 1995/7 - 2009/11 male gap post census 40% gap reduction target male female gap post census 35 40% gap reduction target female 30 25 20 15 10 5 0 95-97 96-98 97-99 98-00 99-01 00-02 01-03 02-04 03-05 04-06 05-07 06-08 07-09 08-10 09-11 three years pooled Success in reducing infant mortality Preventable Mortality in YH 4.03 - Mortality rate from causes considered preventable (provisional) Age-standardised mortality rate from causes considered preventable per 100,000 population England 146.1 Yorkshire and The Humber 159.4 Kingston upon Hull, City of 221.0 Doncaster 175.0 North East Lincolnshire 171.9 Leeds 170.1 Bradford 169.5 Calderdale 169.2 Barnsley 167.4 Wakefield 166.7 North Lincolnshire 160.1 Rotherham 159.8 Kirklees 155.6 Sheffield 155.3 York 139.7 East Riding of Yorkshire 133.1 North Yorkshire CC 130.6 0 50 100 150 Source: Public Health Outcomes Framework (based on ONS source data) Note this is not the same as the overall premature deaths found in Longer Lives 200 250 Deaths from Cancers 4.05i - Under 75 mortality rate from cancer (provisional) 2009 - 2011 Age-standardised rate of mortality in persons less than 75 years per 100,000 population with 95% CIs England 108.1 Yorkshire and The Humber 115.1 Kingston upon Hull, City of 143.1 Barnsley 128.9 Doncaster 128.7 Rotherham 124.1 Wakefield 121.7 Calderdale 120.3 North Lincolnshire 116.9 Sheffield 116.9 Leeds 116.1 North East Lincolnshire 114.1 Bradford 112.8 Kirklees 110.6 York 107.8 East Riding of Yorkshire 101.1 North Yorkshire CC 100.2 0 50 100 Source: Public Health Outcomes Framework (based on ONS source data) 150 200 Liver Disease 4.06i - Under 75 mortality rate from liver disease (provisional) 2009 - 2011 Age-standardised rate of mortality in persons less than 75 years per 100,000 population with 95% CIs England 14.4 Yorkshire and The Humber 15.2 Kingston upon Hull, City of 20.0 Kirklees 18.3 Leeds 17.9 Bradford 17.4 Doncaster 17.1 North East Lincolnshire 16.5 Calderdale 16.0 Rotherham 15.7 Wakefield 15.3 Sheffield 14.0 North Lincolnshire 13.9 Barnsley 13.3 East Riding of Yorkshire 12.4 York 10.8 North Yorkshire CC 10.4 0 5 10 15 Source: Public Health Outcomes Framework (based on ONS source data) 20 25 Infant Deaths 4.01 - Infant mortality 2009 - 2011 Infant deaths under 1 year of age per 1000 live births with 95% CIs England 4.3 Yorkshire and The Humber 5.0 Bradford 7.4 Calderdale 7.1 Kirklees 5.3 Wakefield 5.0 Sheffield 4.9 Kingston upon Hull, City of 4.8 York 4.7 Leeds 4.6 North Lincolnshire 4.6 Doncaster 4.6 Rotherham 4.5 Barnsley 4.1 East Riding of Yorkshire 4.0 North East Lincolnshire 3.8 North Yorkshire CC 3.4 0 2 4 6 Source: Public Health Outcomes Framework (based on ONS source data) 8 10 Variation in TB incidence within Y & H What does this mean for the PHE Centre in Yorkshire and the Humber? We need to work out how we will balance local and national priorities for public health. This doesn’t mean that we simply arbitrate or act as a go between. Our skill will be to build in the areas where there are uncertainties are gaps. Making it local • Health and wellbeing boards • Local Strategic Partnerships • Crime and Disorder Reduction Partnerships • Safeguarding Boards • Voluntary Service Councils • LRFs/LHRPs • Drug and alcohol groups • TB, Tobacco, Education, Physical activity, Air quality, Housing renewal,……. The local public health system Health Related Behaviour. Attractive Cycle Routes And Pleasant Parks Physical Environment Supportive Friendships Social Capital Safe and Friendly Neighbourhoods