Eastern and Coastal KentWest Kent

Health Inequalities in Kent – What can we learn

from Marmot

Meradin PeacheyDirector of Public Health

Mark LemonHead of Policy

Kent Department of Public Health

Eastern and Coastal KentWest Kent

The Life Course of Health

Kent Department of Public Health

Eastern and Coastal KentWest Kent

The Social Gradient of Health Inequalities

Kent Department of Public Health

Eastern and Coastal KentWest Kent

A Kent and Medway example Circulatory disease aged under 75

Kent Department of Public Health

Eastern and Coastal KentWest Kent

Reception Year Child Obesity Levels 08/09 - Kent Local AuthoritiesSource: National Child Measurement Programme

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

<Most Deprived------------------------------------------------------------------------------------Least Deprived>

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Kent Department of Public Health

Eastern and Coastal KentWest Kent

The Conceptual Framework

.

Reduce health inequalities and improve health and well-being for all.

Create an enabling society that maximises individual and community potential.

Ensure social justice, health and sustainability are at heart of policies.

Give every child the best start in

life.

Create fair employment and

good work for all.

Enable all children, young

people and adults to

maximise their capabilities and

have control over their lives.

Ensure healthy standard of living for all.

Create and develop healthy and sustainable

places and communities.

Strengthen the role and impact

of ill health prevention.

Equality and health equity in all policies.

Effective evidence-based delivery systems.

Policy objectives

Policy mechanisms

Kent Department of Public Health

Eastern and Coastal KentWest Kent

Key themes

• Reducing health inequalities is a matter of fairness and social justice

• Action is needed to tackle the social gradient in health – Proportionate universalism

• Action on health inequalities requires action across all the social determinants of health

• Reducing health inequalities is vital for the economy – cost of inaction

• Beyond economic growth to well-being

Kent Department of Public Health

Eastern and Coastal KentWest Kent

Cost of Inaction in lean times

• In England, dying prematurely each year as a result of health inequalities between 1.3 and 2.5 million extra years of life lost – the human cost- 200000 deaths of 30+.

• Economic benefits in reducing losses from illness associated with health inequalities. Each year in England these account for:

– productivity losses of £31-33B

– reduced tax revenue and higher welfare payments of £20-32B

– increased treatment costs well in excess of £5B.

Kent Department of Public Health

Eastern and Coastal KentWest Kent

Making it happen – A framework for delivery

• Increased disability free life expectancy and reduction in inequalities across the gradient.

• Empowering people : securing community solutions.

• Intergovernmental action with dedicated leadership and executive team.

• National Policies need effective local deliver focussed on health equity in all policies.

• New model of civic and public sector leadership grounded in democracy and whole system thinking

• Local Strategic Partnerships of Councils, NHS, 3rd Sector and Private Sector creating the conditions where individuals and communities take control.

• Comprehensive, systematic, scaled up, co-produced action focussed on the social determinants of health.

Kent Department of Public Health

Eastern and Coastal KentWest Kent

Partnerships with individuals and communities

• Critical success factor in addressing health inequalities through empowerment – creating the conditions in which people can take control

– Bespoke individual responses

– Population focused approaches

• Asset based partnership – half full not half empty

– Sharing power

– Community led and long term

– Shift in values and attitudes

– Leadership and knowledge transfer.

• Shared aspirations in improving health and wellbeing

– Perceptions of local schools, health and social care service, housing type,employment,safety and social cohesion.

• Balancing long-term gains and short-term pressures.

Kent Department of Public Health

Eastern and Coastal KentWest Kent

Conclusion

• The Marmot report emphasises that solutions to health inequalities are social not medical

• The recommendations and key principles underpin and develop the ‘Big Society’

• To improve health inequalities communities’ and individual’s resilience needs to be developed

• The relationship between the citizen and the state must be recast

• We should continue to use our proven approaches of Social Marketing and co-production to effect change

Kent Department of Public Health

Eastern and Coastal KentWest Kent

Thank you for listening