community regeneration and health improvement developing an outcomes focused approach
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Community Regeneration and Health Improvement Developing an outcomes focused approach. Erica Wimbush NHS Health Scotland. Outline. Policy drivers An outcomes approach to planning and performance management - PowerPoint PPT PresentationTRANSCRIPT
Community Regeneration and
Health Improvement
Developing an outcomes focused
approachErica Wimbush
NHS Health Scotland
Outline• Policy drivers• An outcomes approach to planning and
performance management • The potential role of community regeneration
in delivering health improvement outcomes – what can be done?
• Community Planning Partnerships – what is the best approach?
Policy drivers
Review of HI performance management
Closing the Gap
Public service reform
Audit of community planning
Taking Stock
New PM framework
for local authorities
Review of HEAT targets
An outcomes approach to planning and performance
management
LONG-TERM OUTCOMES
MEDIUM-TERMOUTCOMES
INPUTS PROCESS OUTPUTS SHORT-TERM OUTCOMES
PLANNING
National level outcomes
Outcome-focused planning & performance reporting
REPORTING
Results for users of delivery
LONG-TERM OUTCOMES
MEDIUM-TERMOUTCOMES
INPUTS PROCESS OUTPUTS SHORT-TERM OUTCOMES
Health outcomes
Reducing inequalities in -
•Physical health
•Mental health
•Well-being
Health determinants
Indiv lifestyle
Social & Community Networks
Living & Working conditions
General socio-economic, cultural and environmental conditions
National level outcomes
Delivery of HI actions
A complex and multi-level system of cross-sectoral partnership-based
delivery
Dahlgren & Whitehead, 2004
The main determinants of health
THE SCOTTISH EXECUTIVEHealth & Well-being Directorate
THE SCOTTISH PARLIAMENTHealth & Social Care CommitteeNational
HEALTH SCOTLAND
COSLALGIS
SCVOVHS
SCCSFHA
HPSISDNESQIS
LTSSHPSU
COMMUNITIES SCOTLAND
FSASSCDCCHEX
14 NHS BOARDSRegional
The planning and delivery infrastructure for Health Improvement Outcomes
32 LOCAL AUTHORITIESCommunity health
projects
Voluntary orgs
COMMUNITY PLANNING PARTNERSHIPS
42 COMMUNITY HEALTH PARTNERSHIPS
LocalLOCAL GOVERNMENT
The potential role of community regeneration in
delivering HI outcomes
What can be done?WHO Europe, 2006
Levelling up (Part 2):a discussion paper on European strategies for
tackling social inequities in healthGöran Dahlgren and Margaret Whitehead
Influencing health determinantsWhat can be done?
• Promoting positive health factors – for example
Economic security, adequate housing and food security Control over life outcomes, good family and social relationships
• Strengthening protective factors – for example
Immunization against infectious diseases; Protection from hazards/community safety; Social support, sense of purpose and direction in life; Healthy diet
• Risk factors/conditions – for exampleLifestyle related risk factors – smoking, excessive drinking and eating; Social or economic risk factors - poverty, low income, unemployment, isolation; Environmental health hazards, such as air pollution, road traffic.
WHO Europe (2006) Levelling Up - Part 2
Reducing health inequalitiesWhich approach?
1. Focusing only on people in poverty or the most deprived localities
2. Narrowing the health divide
3. Reducing social inequities throughout the whole population.
WHO Europe (2006) Levelling Up - Part 2
Economic regenerationWhat can be done?
Economic growth strategies – Health is Wealth• Potential health benefits of economic growth • Population health as a determinant of economic growth;
high social and business costs of poor healthPolicy options for reducing health inequalities • Economic growth recognised as a resource for human
development, esp for disadv groups/areas• Successful growth reduces poverty and income
inequalities, improves living conditions, access to education and healthcare
• Use human development measures of growth - health adjusted measures of GNP, Millennium Dev Goals
WHO Europe (2006) Levelling Up - Part 2
Getting people into work What can be done?
Work environment and unemployment• Positive social aspects of work environment• Health hazards of work – work-related ill-health, stress
and physical safety still a significant factor in burden of disease
• Negative health impacts of unemploymentPolicy options for reducing health inequalities• Health & safety legislation • Actions that remove physical hazards in the workplace
and improve psychosocial conditions• Actions to improve the employability of those out of work • Rehabilitation of those off sick or on incapacity benefit• Develop the workplace as a setting for health promotion.
WHO Europe (2006) Levelling Up - Part 2
Education, learning, skillsWhat can be done?
Education and health • Improved health literacy• Impacts on job opportunities, income level, occupational
stresses/hazards• A route out of poverty for disadvantaged groups and a channel
for social mobility• Empowerment – enabling and encouraging participation in the
community; more control over lifePolicy options for reducing health inequalities • Reduce barriers to gaining access to education and life-long
learning for disadvantaged groups• Comprehensive support programmes for children in less
privileged families, to promote preschool development, prevent school drop-out, and support the school-work transition
• Reduce social segregation within the school system• Health Promoting Schools
WHO Europe (2006) Levelling Up - Part 2
Environmental regenerationWhat can be done?
Environment and health• Housing quality, overcrowding, homelessness,
thermal efficiency, child safety• Security/safety – mental health & injuries from
crime, violence and disorder• Transport/roads – mobility/access to services,
road deaths and injuries• Access to green space – mental health and
physical activity benefits
Social regenerationWhat can be done?
Social and community inclusion strategiesThe extent and quality of social networks,
participation and relationships have– Individual level health impacts– Population level health impacts
Policy options for reducing health inequalities• Bolstering individual social and emotional support • Promoting horizontal integration and interaction • Promoting vertical social interactions and bonds
WHO Europe (2006) Levelling Up - Part 2
Community Planning
What is the best approach to delivering HI outcomes?
Community planningWhat are the priorities?
• Responding to demographic change• Economic growth, job opportunities• Education, lifelong learning, employability/skills• Environment – transport, housing,
neighbourhoods• Social justice, inclusion, equity• Community safety and security• Health improvement
A Better Community LifeCPP Vision
CPP Strategic Objectives
Getting people
into work
Education learning, skills
Health improvement
EnvironmentsCommunity
safety
Responding to demographic change
CPP Actions &Outcomes
National level
outcomes
A Better Scotland
A Better Community LifeCPP Vision
CPP Strategic Objectives
Getting people
into work
Education learning, skills
Health improvement
EnvironmentsCommunity
safety
Responding to demographic change
ROA ROA ROA/JHIPROA ROACPP
Actions &Outcomes
National level
outcomes
A Better Scotland
Wealthier SmarterHealthier Inequalities in
MortalitySustainable Safer
Workless h’holdsUnemployment,
New DealIncapacity Disability
Literacy & numeracy
School absenceFoundation skills
Smoking, Alcohol
Diet, PA, etc
Access to services
Fear of crimeCrime rates
A Better LifeCPP Vision
CPP Strategic Objectives
Responding to demographic change
CPP Actions & Outcomes
National level
priority outcomes
A Better Scotland
Reducing health inequalities
Getting people
into work
EducationLearning, skills
Social inclusion
EnvironmentsCommunity
safety
Health determinants