Transcript Document

Setting the Context
JSNA workshop for Southampton
Angela Donkin
UCL Institute of Health Equity
Life expectancy in Southampton
LE male
LE female
England
78.3
82.3
Southampton LA
78.4
82.4
Bassett
80.6
84.0
Bitterne
75.3
79.9
While inequalities are stark, Southampton LA has lower than average inequalities compared to the rest of England, yet higher than
average inequalities compared to the South East region.
Policy Objectives: The Social Determinants of
Health
A. Give every child the best start in life
B. Enable all children, young people and adults to maximise their
capabilities and have control over their lives.
C. Create fair employment and good work for all
D. Ensure a healthy standard of living for all
E. Create and develop healthy and sustainable places and communities
F. Strengthen the role and impact of ill-health prevention
A. Giving every child the best start in life
Children achieving a good level of development at age five, local
authorities 2011
•
Good level
of development
at age 5
%
80
75
70
65
60
55
50
45
40
0
30
60
90
120
Local authority rank - based on Index of Multiple Deprivation
150
Southampton – Development at age 5
Good devt %
England Ave
Southampton LA
England Best
55.7
53.9
69.3
School Ready at Age 5 will be measured as part of the Public Health Outcomes Framework, and
likely to be based on scores on the Early Years Foundation Stage Profile.
A. Give every child the best start in life
• Negative early years experiences and poor development
are highly predictive of negative later life outcomes in
health but also crime, low educational attainment, future
benefit dependency, teenage pregnancy etc.
• Existing outcomes frameworks give good indication of
what children should be expected to be able to do, focus
on school ready for age 5, use these - but need to start
early.
• Need more focus on parenting and quality of home
learning environment – we are developing new framework
for children’s centres. Use midwives, health visitors and
GPs to give messages and support from conception
A. Give every child the best start in life. Socio-emotional difficulties at age 3
and 5: Millennium Cohort Study
Age 3
Age 5
Fully adjusted = for parenting activities and psychosocial markers
Kelly et al, 2010
B. Enable all children, young people and
adults to maximise their capabilities and
have control over their lives.
• Continued priority to reducing inequalities in
education outcomes
• Prioritise inequalities in life skills (whole child
approach, full service schools, workforce)
• Increase access and use of quality lifelong
learning (16-25 yr old support, work based
learning, non-vocational courses)
C. Create fair employment and good work for all
• Prioritise active labour market programmes
• Quality of jobs improved (equality legislation, well
being, stress and mental health at work)
• Security and flexibility of employment (retirement
and people with poor health and caring
responsibilities)
Southampton NEET – not in employment,
education or training
10.2% of Southampton’s 16-19 year olds are NEET,
compared to 6.3% across the UK. Significantly
higher.
Recession has hit hard on young people. Will
impact on mental health, drug and alcohol
dependency and suicides. Also has long term
detrimental effect on labour market outcomes.
Tackle youth unemployment, and ensure sufficient
resources in mental health and drug/alcohol support
D. Ensure a healthy standard of living for all
• Lack of money, and particularly debt increase
stress. They lead to an increase in mental health
conditions, and to family conflict, and post natal
depression – all bad for the parent and the child.
• Fear of loss of income/employment is also a
stressor.
• Also need an absolute level of income to meet
daily needs.
• Increase in number reporting fuel, and food
poverty.
D: Ensure a healthy standard of living for all
E. Create and develop healthy and
sustainable places and communities
• Combining policies to mitigate climate change and health (active
travel, green space, food environment, energy efficiency)
• Integrate planning, transport, housing environmental and health
systems
• Regeneration based on reducing social isolation and remove barriers
to action
F. Strengthen the role and impact of ill health
prevention
• Smoking, obesity, lack of physical activity and
unhealthy nutrition all follow the SE gradient:
• Increase and improve the scale of medical drug
treatment programmes
• Focus public health interventions (e.g. alcohol
reduction or smoking cessation) on reducing the
social gradient
• Improve programmes to address the causes of
obesity across the social gradient.
• Focus on interventions related to the SDH.
Thank you
[email protected]
http://www.instituteofhealthequity.org