Dr. Ash MorePublic Health Specialist

Lambeth & Southwark Public Health

21 wards Diverse Densely populated (9th highest)

Increasing population Total resident population =288,200 BAME population – 46%

12th most deprived in London

Some areas in the 20% most deprived regions in England

Life Expectancy Southwark Males = 78.2 years (England = 79.2)Life Expectancy Southwark Females = 83.4 years (England = 83.1)

Source: NCHOD, 2012

Southwark

Lambeth

Census 2011 288,300 303,100

GP Population 329,000 384,700

Deprivation 12th in London41st in England

9th in London29th in

England

LE – Males 78.2 77

LE - Females 83.4 81.1

Births each year

5131 4929

Infant Mortality

5.3 6.2

Circulatory dis mortality <75

73 87

Cancer mortality <75

101 115

TP 53.3 58.1

ACSC 356 309

Alcohol rel. hosp admissions

1808 1853

WardsBrunswick Park Camberwell Green Cathedrals Chaucer College East Dulwich East Walworth Faraday Grange Livesey Newington Nunhead Peckham Peckham Rye Riverside Rotherhithe South Bermondsey South Camberwell Surrey Docks The Lane Village

WardsBishop’sBrixton HillClapham CommonClapham TownColdharbourFerndaleGipsy HillHerne HillKnight’s hillLarkhallOvalPrince’sSt Leonard’sStockwellStreatham HillStreatham SouthStreatham WellsThorntonThurlow ParkTulse HillVassall

Smoking – 1 in 5 (21%) adults smoke

Obesity– 1 in 5 (22%) adults are obese

Alcohol– 1 in 5 (20%) adults are high risk drinkers

Sexual health – High STI rate + TP rate

Source: Office for National Statistics (ONS)

Health Inequalities are unfair & avoidable differences in health between different population groups.

Health inequalities follow a socioeconomic gradient: Risk of illness and deaths increases with deprivation.

Life expectancy gap Infant mortality rate Premature mortality from cancer and CVD Child poverty Health poverty Educational achievement Economic inequality Deprivation levels Mental ill-health ….others.

All age all cause mortalityPreventable premature mortality from cancer; CVD; respiratory

disease; liver diseaseMortality from causes amenable to

health care* Smoking prevalence

Adult obesity prevalence*Teenage conceptions

Emergency hospital re-admissions*Unplanned hospital admissions

(ACS)*

Infant mortalityPhysical activity adults*

Childhood vaccination related diseases

Childhood tooth decay*Suicide*

Preventable sight lossExcess winter deaths*

Vit D deficiency ricketsRoad traffic injuries / mortalityMortality from communicable

diseasesLow birth weight

Injuries in ChildrenInjuries in young people

TB incidence

Hypertension prevalenceAlcohol related burdenDrugs related burden*

Childhood obesitySexual Health burden (HIV, STIs)

Lower prevalence of LTC (lower detection)*Falls injury (older people)

Wider determinants of health burdenViolence related health burden*

Low wellbeing levels*Mental ill-health

Social isolation in adult social care usersHip fractures in elderly

Thematic Areas Proposed priorities

Maternity & new born

-Prevention of SIDs-UNICEF baby friendly initiative + breast feeding-Enhance joint working on housing

Children & Young People

-Promote healthy eating & physical activity-Improve immunisation uptake-Promote safe sex-Improve access to effective care for chronic conditions

Staying Healthy -Improve smoking cessation performance-Promote prevention - interventions for alcohol, diet and physical activity-Promote uptake of NHS Health checks-Improve cancer awareness and screening coverage.

Long term conditions -Strengthen primary prevention-Focus on effective behaviour change-Improve detection of undiagnosed LTCs-Improve uptake of HIV testing in primary care

Older people -Priorities include improving dementia diagnosis - Provision of community support and management of OP with chronic conditions

Disabilities & LD -Improve PWLD recording at primary care , promote independent living and support PWLD with additional needs

Mental health -Develop mental health promotion-Reduce referrals, improved detection and management in primary care

Health Inequalities -Focus on key factors affecting infant mortality such as antenatal booking-Reduce hospital admissions due to LTCs and ACSCs, -To address wider determinants of health and improve outcomes in deprived parts

Service level priorities Reducing A&E 4 hour waits Reducing cancer referral and waiting times Timely access to maternity service Improving child and seasonal immunisation Reducing MRSA and CDiff incidence Access to primary care services Increasing screening uptake Improving patient experience

Public health priorities Reducing premature and all cause mortality Reducing smoking prevalence Reducing teenage conceptions Reducing levels of child and adult obesity

Regional Early diagnosis and treatment of HIV TB treatment completion rates

Source: Department of Health

1. High deprivation, high diversity and high population mobility.

2. Smoking, alcohol/substance misuse, unsafe sex and unhealthy lifestyle are issues to be tackled.

3. Health inequalities evident in the local population.

4. Prevention or effective management of diseases/condition to improve health outcomes is essential.

5. Health priorities reflect the current identified health and wellbeing needs through the JSNA.

6. Need to continue to address local health and wellbeing issues to improve outcomes and reduce health inequalities.

Source: Joint Strategic Needs Assessment

Priority 1: Giving every child and young person the best start in life

Priority 2: Building healthier and more resilient communities and tackling the root causes of ill health

Priority 3: Improving the experience and outcomes for our most vulnerable residents and enabling them to live more independent lives

Health and Wellbeing Strategy