Download Tackling the wider determinants of health

Tackling the wider
determinants of health:
Health Improvement Domain
Andrew Jones
Regional Director/ Director of
Health Improvement
National Policy and Direction
in Wales
• ‘Designed for Life’
• Commitment to deliver world class
healthcare services and a clear focus on
tackling health inequalities.
• Public Health Strategic Framework
• Key Strategic themes/priorities
Strategic Management by
Domain
• National Director
• Directors with specified responsibilities
–
–
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–
Health Improvement
Health Protection
Health and Social Care Quality
Health Intelligence
• Public Health Management Group
• Public Health Executive Team
• Four Domain Strategic Management Groups
NPHS Direction
• Business Plan : 2005-2008
– Strategic Goals and Objectives
• National and Local work plans
– Key tasks for delivery
• Agreed with partners/stakeholders
Health Improvement Domain
“to improve the health and well-being of the
population and reduce inequalities.”
• Focus on strategic priorities and actions
relating to the wider social, economic and
environmental determinants of health.
• Social model of health
• Support national policy and local delivery
Health Improvement Domain
• Specialist public health advice aimed at
supporting partners/stakeholders to work
together to:
– Address the root causes of poor health,
– Promote ‘Investment for Health’ and
– Reduce health inequalities.
• Link to other Domains as required
Domain Management Group
• Chaired by Director
• Senior staff specialising within the domain
• Representation from Local Public Health
Directors
• Cross representation from other domains
• Wider engagement as appropriate
Moving from this
Environment
Public economic
strategies
Traffic
Agriculture
& food
Education
Sex &
life together
Leisure &
culture
Social-insurance
Eating habits
§
Illicit drugs
Social
network
Housing
Employment
?
Alcohol
Tobacco
Work
environment
Physical
activity
Age, sex,
heredity
Social
support
Contact
children
and adults
Social
assistance
Sleep
habits
Health-&
medical care
…..to this
Haglund, Svanström, KI, revision, Beth
Hammarström
Domain Structure
• 3 Areas to address the broad range of
determinants of health
• Economic and Physical Environment
– housing, transport, waste, economic development,
corporate health standard
• Influencing Behaviours
– tobacco, alcohol, nutrition, physical activity, substance
misuse, sexual health
• Communities and Families
– Focus on children e.g. child poverty, community
development, schools, mental health promotion
Service Delivery
• Local Public Health Directors/Teams
• Domain support
– ‘Lead’ Consultant in Public health in each of 3 areas
– Dedicated practitioner support in each of 3 areas
– Defined services – smoking cessation/ workplace
health
– Use of ‘Advisory’ roles using expertise from LPHTs
– Task and Finish Teams/ Networks
– Key links to partners e.g. Wales Centre for Health,
Local Government
Specific Managed Programmes
• All Wales Smoking Cessation Service
– National public health programme
– Community focus
– Pre –operative service ( NHS performance
target)
– Targeted services (maternity, mental health,
manual workers)
• Corporate Health Standard
Some challenges
• Task and Finish groups to address:
• Economic and Physical Environment
– Welsh Backs project
– Injury Prevention
– Climate change/Sustainable Development
Influencing Behaviours
– Obesity
– Tobacco
– Alcohol misuse/Prevention Programmes
• Communities and Families
– Child Poverty
– CEHAPE (Children’s Health Action Plan - European)
Economic and Physical
Environment Priorities
• Health at Work
• Economic inactivity
• Economic and physical regeneration
(spatial plans)
• Sustainable Development - climate
change, heat wave plan, KWTW
• Housing and built environment
• Injuries
Influencing Behaviours Priorities
• Prevention and early intervention – link to chronic
disease care pathways
• Tobacco
– Cessation
– Prevention – ASSIST ( and more e.g. social marketing)
– Environment ( Tobacco ban in public places)
• Obesity
– nutrition and physical activity
• Alcohol misuse – comprehensive public health
programme
Communities and Families
• Child Poverty
• Children and Young People partnerships
• Healthy Schools
• Settings – next year Prison health
Working with Stakeholders
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•
•
•
•
Welsh Assembly Government
Local Health Boards
Local Government
Wales Centre for Health
National partners e.g. Health Protection
Agency, Environment Agency
• Independent and voluntary sector
Research and Development
• Link to academic public health
• Promote research and evaluation
• Contribute to development of public health
evidence base
• Share best practice
Wales and beyond
• Work within UK ( other devolved
administrations Scotland, Ireland etc)
• Europe – Children’s Environmental Health
Action Plan (CEHAPE)
• International Public Health
Added Value
• How can we best work together across
NPHS to deliver a world class specialist
advice service to promote health
improvement and address health
inequality?