Transcript An effective public health approach to promoting health

An effective public health approach
to promoting health and wellbeing
for older people – lessons for local
government
Adrian Phillips
Birmingham
General approach..
• Define the question
• Assess the need
• Use the evidence until it hurts
– Do what works
– Don’t do what doesn’t work
– Invest in answering uncertain questions
• Evidence strongest for individual treatments
(and there is loads), less so for population
change
The healthy ageing conundrum
• What is the question?
–
–
–
–
Is it an age? (in which case look at houses of parliament..)
Is it a physical state? (how worn out do we need to be?)
Is it a mental state? (dementia or just a bit forgetful?)
Is it just before death? ( a pretty conclusive outcome but
often uncertain in arrival)
– Is it homogenous? (first generation Asians, the Welsh!)
– Is it just avoiding expensive care (health and social)?
• Is it more about us?
• 1st thought – be clear on the question
What are the outcomes we want?
• Salvage – recovering after hip fracture, cataract etc.
• Prevention – avoiding the second fall, stopping flu,
controlling diabetes, early diagnosis of bowel cancer
etc.
• Promotion – related to populations, how our society
works and interacts with individuals?
• 2nd thought – be clear on desired
outcomes
– Does it vary by phase?
Some thoughts on outcomes
• Stabilising communities
• Noticing what goes on (I'm not nosy, just
interested..)
• Maximising life-long skills and still picking new
ones up (silver-surfers)
• Proud to help others especially in an unpaid
capacity
• Being a good role model for younger people
especially behaviour to others and personal
physical activity
Steps to wellbeing
•
•
•
•
•
Connect
Take notice
Keep learning
Give
Be active
• 3rd issue – do we need to challenge our thought
paradigm on population promotion (very
different to traditional NHS outcomes of deaths,
admissions)
Do we understand how population’s
take steps?
• Positive steps
– Incentives, rewards, feel good
• Barriers to steps
– Finance, safety, ill-health , ignorance, transport,
lack of connectivity
• What is the “offer”?
• Do we understand the expectations and fears
of this group?
Older People Emerge As A Mentoring Force
Online
PRLog - Jan. 19, 2010 - The potential for online mentoring to
unlock and use the wisdom of older, experienced and retired
professionals is demonstrated today by the winners of the Yell
and horsesmouth Mentoring Works Awards. The three
awards for business mentoring, which were drawn from user
nominations on the online mentoring website
horsesmouth.co.uk have all been won by individuals over the
age of 50.
3 issues
• Clarity on the question
• Definition of the desired outcomes
• Challenge traditional thinking on population
promotion
Ageing
• Life course defined in utero (may even start with
your grandmother)
• Is an evidence base for individual interventions,
some of which are scale-able, few increase
individual control
–
–
–
–
–
Flu
Cognitive behavioural therapy
Smoking cessation
Physical activity
Excess weight loss…