public health challenges in the south west
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Public Health challenges in the South West. Dr Shona Arora Centre Director, Avon, Gloucestershire and Wiltshire Public Health England. Key Issues. Demographic pressures Inequalities Financial challenges for Local Authorities & the NHS - PowerPoint PPT PresentationTRANSCRIPT
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Public Health challenges in the South West
Dr Shona AroraCentre Director, Avon, Gloucestershire and
Wiltshire Public Health England
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Key Issues
– Demographic pressures– Inequalities– Financial challenges for Local Authorities & the
NHS
Wider, but fragmented system – how do we work together?
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(Some) Shared priorities
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Public Health Outcomes Framework
Where is the SW an overall outlier?• Healthcare and preventable mortality:– suicides (5/13 LAs worse than national)
• Health Improvement:– Smoking in pregnancy (4/13 LAs)– Excess weight in children (6/13)– Injuries in young people (4/13)– Health checks take up (7/13)
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SW demographic pressures
England Cornwall I of S Plymouth Torbay Devon Bristol N Som Somerset South G BANES Glouc Swindon Wilts0%
5%
10%
15%
20%
25%
30%
18%
23%22%
17%
26%25%
13%
23%24%
18%19%
22%
15%
20%
65+ 2015
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Change in healthcare consumption
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Long term health problems
Cornwall Plymouth Torbay Devon Bristol North Som Somerset South Glos BANES Gloucs Swindon Wilts0%
2%
4%
6%
8%
10%
12%
14%
Long Term Health Problems
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Healthy life expectancy
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LGA Graph of Doom
• Councils were cut earlier and harder than the rest of the public sector as the government began to implement its deficit reduction policy
• •National gap in income versus expenditure of £16.5b by 2019/20
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Inequalities• Marmot review (2010) ‘Fair Society, Healthy Lives’
• Differences in health outcomes reflect, and are caused by, social and economic inequalities in society
• Genetics, lifestyle and access to healthcare are not the only factors that cause health inequalities
• People in poorer areas die earlier but spend more of their shorter lives with a disability
• Cost to NHS = More than £5bn a year
• Response needs to be across the lifecourse, and proportionate to need
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Life Expectancy and deprivation in the SW
• Life expectancy continues to rise generally but is below the national average in certain parts of the SW:– E.g. Plymouth, Gloucester, Swindon
• Gaps in life expectancy of 8+ years within some areas• Deprivation varies across the SW, which also has some of the
least deprived areas in England, but is often in small pockets in more affluent LAs
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What contributes to health inequalities?
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Wider determinants of health – the causes of the causes
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Influences on population health
King’s Fund summary:
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Impact of social relationships on health
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Public Health Challenges
• What is the balance between the full range of actions we need to take – from prevention to palliation, from cradle to grave , that will ensure health & wellbeing into the future, and help to ensure are services are affordable?
• How do we stop health inequalities from increasing?• How do we build a lifecourse approach into our
approach to the challenges facing health & social care?• How do we develop a stronger evidence base? And
disseminate good practice and evidence more quickly?
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Link between social and health inequalities
• How can the NHS take action?– Treating patients – Every
Contact Counts, PH in Clinical Networks
– Community leadership through H&WBB – action on wider determinants
– Advocacy for most disadvantaged
– Preventative Strategies, e.g. primary care