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Health priorities for Charnwood, 2010 and beyond

Health priorities for Charnwood, 2010 and beyond. Dr Mike McHugh Consultant in Public Health NHS Leicestershire County and Rutland 7/9/10. What is health?. ‘ Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity’

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Health priorities for Charnwood, 2010 and beyond

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  1. Health priorities for Charnwood,2010 and beyond Dr Mike McHugh Consultant in Public Health NHS Leicestershire County and Rutland 7/9/10

  2. What is health? ‘Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity’ WHO, 1948

  3. Charnwood Demography • 164,800 people • 86% ‘white British’ • 3% ‘white other’ • Sizeable populations of South Asian people i.e. Indian and Bangladeshi in Loughborough • Charnwood is more affected by socio-economic deprivation than Leicestershire as a whole • Loughborough and Shepshed are less affluent and smaller

  4. Levels of Health in Charnwood • Health of people in Charnwood generally better than England average • Life expectancy significantly higher for both men and women • Levels of drug misuse, hospital stays for alcohol related harm, deaths from smoking and road injuries and deaths all appear better than average BUT…

  5. BUT.. …the Tyranny of averages .. and also the issue of health inequalities

  6. Children and Young People • Diagnosis of children (aged 15 years and under) with Autistic Spectrum Conditions (ASC) has increased ten-fold in the last 10 years. • 286 teenage conceptions: 2004-2006 • 18% of Leicestershire pupils in year eight and 10 reported using drugs (national average 16%) • 9.3% of reception age children obese • 23.8% are overweight or obese • 15% of year 6 children are obese, 30% are overweight or obese

  7. Adults • Charnwood has highest premature mortality from cardiovascular diseases in LCR: 401 premature deaths (2004-2006) • 21,839 people on GP registers with diagnosed Hypertension (15.3% of the adult population) • 6,794 people are on GP diabetes registers • 1,959 people on GP registers with chronic obstructive pulmonary disease

  8. Adults continued • 34,088 adults are obese (highest out of all other districts) • Only 27.7% of adults eat 5 portions of fruit or vegetables per day • Only 26% of the adult population exercise for 30 minutes or more at least 3 times per week • 24,175 binge drinkers, 26,027 hazardous drinkers, 5,953 harmful drinkers • 31,564 adults smoke

  9. Smoking • biggest preventable cause of premature death and illness • biggest driver of inequalities • relatively quick impact in CVD • What are we doing about it? (Smokefree Future 2010) • motivating and assisting every smoker to quit • stopping the inflow of young people recruited as smokers • protecting families and communities from tobacco-related harm

  10. Older people • In 2008 11,101 people over 65 had a limiting long term illness • 8,162 people over 65 years unable to self care • Proportion of elderly increasing • Biggest use of resources in urgent care • Continuing care • Dementia care

  11. Health Inequalities • Significant health Inequalities exist within Charnwood e.g. men from least deprived areas can expect to live over 9 years longer than those in most deprived areas

  12. All age all cause mortality

  13. We don’t just have socio-economic inequity • BME • Asylum seekers • Homeless • Travellers • Offenders • Sexual orientation • Gender • Age • Rurality

  14. Health inequities ‘The presence of systematic disparities in health (or its social determinants) between more and less advantaged social groups’ Defining equity in health, J Epidemiol Community Health 2003, 57(4):254-258

  15. What causes health inequity? “If the causes of health inequalities are social, economic, cultural and political, then so should be the solutions.” -Sir Michael Marmot, Chair of the Scientific Group on Health Inequalities 2010

  16. So what can we do to tackle health inequalities in Charnwood?

  17. 1.Support families, mothers and children • Close the gap in infant mortality between advantaged and disadvantaged communities • Improve maternal and child health, and child development

  18. 2.Engage communities and individuals • Strengthen disadvantaged communities • Tackle crime and substance misuse • Support vulnerable groups • BME • Older • Mentally ill/LD • Homeless • Offenders • Travellers • Asylum Seekers • Rural

  19. 3.Prevent illness and provide effective treatment and care • Reduce risk through effective prevention • Early detection, intervention and treatment • Improve access to effective treatment • CVD • Cancer • Diabetes • Mental illness • OTIMISE NHS CARE

  20. 4. Address underlying (wider) determinants of health • Poverty (especially child poverty) • Early years, parenting • Education, training and skills • Employment • Social Cohesion • Housing • Transport

  21. Strategic Goals for NHS LCR • Tackling major killers • Cardio vascular disease (CVD) mortality • Cancer mortality • Tackling major risk factors • Smoking • Alcohol • Diabetes control • Better quality services • Complex elderly • Mental health • End of life • Patient experience Life expectancy and inequalities are overarching One priority outcome in each goal…….

  22. Charnwood Priorities: Summary • CYP issues-teenage pregnancy, obesity, drugs, alcohol • Adults- Premature mortality-CVD, cancer, obesity • Older: increasing population • Health Inequalities

  23. Let’s focus on • Partnership working to address health inequalities-smoking, substance abuse, alcohol, obesity, teenage pregnancy/sexual health • Remember wider determinants of health • Engage socially excluded • Premature mortality • Children, young people, parenting, families • Let’s get most out of NHS-work with primary care

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