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A Public Health Perspective

A Public Health Perspective. Dr Chris Kenny, DPH NHS Nottinghamshire County NHS Bassetlaw Nottinghamshire County Council. The presentation. Public health perspective on children’s health issues and inequalities Regional and locality focus – the data

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A Public Health Perspective

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  1. A Public Health Perspective Dr Chris Kenny, DPH NHS Nottinghamshire County NHS Bassetlaw Nottinghamshire County Council

  2. The presentation • Public health perspective on children’s health issues and inequalities • Regional and locality focus – the data • How Health and Wellbeing Boards can improve how we address these issues • Opportunities and risks

  3. Key health issues • Child population – under 5s • Child poverty • Teenage pregnancy • Smoking in pregnancy • Low birth weight and infant mortality • Breast feeding • Immunisation & vaccination • Obesity, emotional health, substance misuse • The health of vulnerable groups

  4. Child population by region: 0-5 years Source: Births data & ONS

  5. Child poverty by region Source: APHO Community Health Profiles, Department of Communities and Local Government and ONS • Child poverty is significantly associated with poor health outcomes. • Infant deaths 50% more common in manual class households • Worse employment prospects at age 23

  6. Child Poverty in Nottinghamshire (2008) by ward • 16.8% of children (under the age of 20) are living in poverty in the county, which equates to 27,080 children • Marked geographical inequalities across the county

  7. Source: National Centre for Health Outcomes Database, www.nchod.nhs.uk

  8. Ward level teenage conception data 2006-2008 • All districts but one have a teenage conception hot spot ward • One ward has a teen conception rate of 160.4 conceptions per 1000 females aged 15-17 yrs (England rate 38.2)

  9. Smoking in pregnancy (by Nottinghamshire providers) Source: NHS Nottinghamshire County, 2010

  10. Low birth weight within Nottinghamshire Percentage of live and still births <2500g, England, East Midlands and district local authorities in Nottinghamshire, 2007 Source: Compendium of Clinical and Health Indicators. Department of Health November 2007

  11. Ward level data for low birth weight in Nottinghamshire % of low birth weight babies in Nottinghamshire wards compared to the Nottinghamshire average (2003-2007)

  12. Infant mortality: Nottinghamshire and local authority statistical peers 2008 Source: Compendium of Clinical and Health Indicators NCHOD, 2010

  13. Breastfeeding % of babies totally/partially breastfed at 6-8 weeks, comparing ONS PCT comparator group, 2009/10 Q3 Source DH PCT Returns 2009/10

  14. Immunisation & vaccination by Practice Based Commissioning Groups, in Nottinghamshire, 2008/9 % of children who have received routine vaccinations by specific ages Source: COVER Data 2010, see above

  15. So what? • The data shows marked inequalities in health outcomes between and within local authority areas, between and within Clinical Commissioning Group areas • To reduce inequalities and improve outcomes for children and young people, we need joint working across local authorities, health services, local communities

  16. Improving outcomes for children: the role of theHealth and Wellbeing Board

  17. Opportunities • Key players in commissioning and providing services for children are involved • JSNA and HWB Strategy focus • CCG Commissioning plans reviewed • Establish clear accountability structures, with direct link between Children’s Partnerships and HWB • Development of commissioning arrangements

  18. In Nottinghamshire.. • Key issues paper presented at HWB in July • CYP JSNA refreshed, for inclusion in main JSNA and HWB Strategy • Clear lines of accountability between HWB, Children’s Trust Executive, joint commissioning groups and NSCB established

  19. Challenges • Maintaining focus on children – competing priorities for HWB • Complexity and lack of clarity – new commissioners, new providers, changes in schools...who is doing what? • Impact that changes to children’s services in one organisation have on other services and children’s health outcomes not understood or considered • Financial constraints

  20. A Public Health Perspective Dr Chris Kenny, DPH NHS Nottinghamshire County NHS Bassetlaw Nottinghamshire County Council

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