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Health and Wellbeing
Health Service Executive
Healthy Ireland – The policy context for addressing health inequalities in Ireland
Dr. Stephanie O’Keeffe, National Director, Health and Wellbeing
22
Why: Health Check
EU goal +2 years of healthy life expectancy & reduction in health inequalitiesLife expectancy has improved but… obesity and predicted increases in chronic diseases and cancers stand in the wayPopulation GrowthPopulation Ageing +65s and +85s
33
Health Check Half of people over 50 have one chronic disease, 11% have
more than one (TILDA). 20% to 40% increase expected in major chronic diseases by
2020. Three quarters of deaths in Ireland are due to three chronic
diseases – cancer, CVD and respiratory diseases, which are largely preventable.
Death rates: social class gradient 100-200% higher in lower SES. This pattern is true for cancers and CVD and markedly so for respiratory disease.
Context - Health Trends
Diet and nutrition Smoking Alcohol Physical Activity Hypertentsion Mental wellbeing Ageing population Chronic disease ↑ Healthcare sustainability €
International Strategic Context
Deviation of life expectancy at birth from average life expectancy by deprivation ranking
Social determinants of Health Inequalities 1
Life Expectancy by Social Class, Republic of Ireland, 2010
Social determinants of Health Inequalities 2
Low High
Educational inequality and obesity
Obesity and education level, females, Eurothine Study , 2009
Obesity: Systemic risks require systemic solutions
Healthy Ireland
Healthy IrelandA Framework for Improved Health and Wellbeing2013-2025
Vision: where everyone can enjoy physical and mental health and wellbeing to their full potential, where wellbeing is valued and supported at every level of society and is everyone’s responsibility.
Healthy Ireland Goals
Goal 1: Increase the proportion of people who are healthy at all stages of life
Goal 2: Reduce health inequalities Goal 3: Protect the public from threats to health and
wellbeing Goal 4: Create an environment where every individual
and sector of society can play their part in achieving a healthy Ireland
1212
Framework of Actions
Governance and PolicyPartnerships and Cross-Sectoral WorkingEmpowering People and CommunitiesHealth and Health ReformResearch and EvidenceMonitoring, Reporting and Evaluation
National Strategic Context
Improved health and wellbeing one of four pillars of reform in Future Health A Strategic Framework for Reform of the Health Service 2012-2015
Future Health and Healthy Ireland underline commitments at national level and service wide to reform our services and systems toward a renewed focus on chronic disease prevention and improved health and wellbeing
1414
Context: Health Service Reform
What works: learn from tobacco
Multiplier effects
1717
Health and Wellbeing: Priority Areas for Implementation
Reform H&W objectives embedded across health reform programmes
Capacity for system-wide implementation and reportingNational Leads and implementation plans for: child health and wellbeing, positive ageing, tobacco control, healthy eating and physical activity, alcohol misuse, sexual health
Health and Wellbeing: Priority Areas for Implementation
Models of care: Integrated clinical care programmes underpinned with prevention National Framework for self care in 2015 National model for brief intervention – every contact counts Consistent data capture on HIPE for lifestyle factors and interventions Generic model of care for chronic disease prevention and management
Health Service Staff improved levels of health and wellbeing
Site specific Healthy Ireland implementation plans: Hospital Groups & CHO
Key enablers Fit for purpose H&W Division Evidence and building a ‘Knowledge Management’ function
& capacity Communications strategy: patient and population
empowerment Partnership and strengthen frameworks and infrastructure
for delivery Capacity for sustaining the agenda nationally
Setting the groundwork for increased investment in prevention
Thank you. Questions