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Health priorities for Charnwood, 2010 and beyond. Dr Mike McHugh Consultant in Public Health NHS Leicestershire County and Rutland 7/9/10. What is health?. ‘ Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity’ - PowerPoint PPT Presentation
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Health priorities for Charnwood,2010 and beyond
Dr Mike McHughConsultant in Public Health
NHS Leicestershire County and Rutland
7/9/10
What is health?
‘Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity’
WHO, 1948
Charnwood Demography
164,800 people 86% ‘white British’ 3% ‘white other’ Sizeable populations of South Asian people i.e.
Indian and Bangladeshi in Loughborough Charnwood is more affected by socio-economic
deprivation than Leicestershire as a whole Loughborough and Shepshed are less affluent and
smaller
Levels of Health in Charnwood
Health of people in Charnwood generally better than England average
Life expectancy significantly higher for both men and women
Levels of drug misuse, hospital stays for alcohol related harm, deaths from smoking and road injuries and deaths all appear better than average
BUT…
BUT..
…the Tyranny of averages
.. and also the issue of health inequalities
Children and Young People
Diagnosis of children (aged 15 years and under) with Autistic Spectrum Conditions (ASC) has increased ten-fold in the last 10 years.
286 teenage conceptions: 2004-2006 18% of Leicestershire pupils in year eight and 10
reported using drugs (national average 16%) 9.3% of reception age children obese 23.8% are overweight or obese 15% of year 6 children are obese, 30% are
overweight or obese
Adults
Charnwood has highest premature mortality from cardiovascular diseases in LCR: 401 premature deaths (2004-2006)
21,839 people on GP registers with diagnosed Hypertension (15.3% of the adult population)
6,794 people are on GP diabetes registers 1,959 people on GP registers with chronic
obstructive pulmonary disease
Adults continued
34,088 adults are obese (highest out of all other districts) Only 27.7% of adults eat 5 portions of fruit or vegetables
per day Only 26% of the adult population exercise for 30 minutes
or more at least 3 times per week 24,175 binge drinkers, 26,027 hazardous drinkers, 5,953
harmful drinkers 31,564 adults smoke
Smoking
biggest preventable cause of premature death and illness
biggest driver of inequalities relatively quick impact in CVD
What are we doing about it? (Smokefree Future 2010)
motivating and assisting every smoker to quit stopping the inflow of young people recruited as
smokers protecting families and communities from tobacco-
related harm
Older people
In 2008 11,101 people over 65 had a limiting long term illness
8,162 people over 65 years unable to self care
Proportion of elderly increasing Biggest use of resources in urgent care Continuing care Dementia care
Health Inequalities
Significant health Inequalities exist within Charnwood
e.g. men from least deprived areas can expect to live over 9 years longer than those in most deprived areas
All age all cause mortality
We don’t just have socio-economic inequity BME Asylum seekers Homeless Travellers Offenders Sexual orientation Gender Age Rurality
Health inequities
‘The presence of systematic disparities in health (or its social determinants) between more and less advantaged social groups’
Defining equity in health, J Epidemiol Community Health 2003, 57(4):254-258
What causes health inequity?
“If the causes of health inequalities are social, economic, cultural and political, then so should be the solutions.”
-Sir Michael Marmot, Chair of the Scientific Group on Health Inequalities 2010
So what can we do to tackle health inequalities in Charnwood?
1.Support families, mothers and children
Close the gap in infant mortality between advantaged and disadvantaged communities
Improve maternal and child health, and child
development
2.Engage communities and individuals Strengthen disadvantaged communities Tackle crime and substance misuse Support vulnerable groups
BME Older Mentally ill/LD Homeless Offenders Travellers Asylum Seekers Rural
3.Prevent illness and provide effective treatment and care
Reduce risk through effective prevention Early detection, intervention and treatment Improve access to effective treatment
CVD Cancer Diabetes Mental illness
OTIMISE NHS CARE
4. Address underlying (wider) determinants of health Poverty (especially child poverty) Early years, parenting Education, training and skills Employment Social Cohesion Housing Transport
Strategic Goals for NHS LCR
Tackling major killers
Cardio vascular disease (CVD) mortality
• Cancer mortality
Tackling major risk
factors
Smoking
• Alcohol
• Diabetes control
Better quality services
Complex elderly
• Mental health
• End of life
• Patient experience
One priority outcome in each goal…….Life expectancy and inequalities are overarching
Charnwood Priorities: Summary
CYP issues-teenage pregnancy, obesity, drugs, alcohol
Adults- Premature mortality-CVD, cancer, obesity
Older: increasing population
Health Inequalities
Let’s focus on
Partnership working to address health inequalities-smoking, substance abuse, alcohol, obesity, teenage pregnancy/sexual health
Remember wider determinants of health Engage socially excluded Premature mortality Children, young people, parenting, families
Let’s get most out of NHS-work with primary care