Download Consultations - Lancashire County Council

Adult Social Care and Health Overview and Scrutiny Committee
Meeting to be held on 16th February 2010
Part I - Item No. 4
Electoral Division affected:
All
Health Inequalities in Lancashire
Contact for further information:
Deborah Harkins, Head of Joint Health Unit, 01772 535186, Policy Unit, Office of the
Chief Executive, [email protected]
Executive Summary
There are significant health inequalities between places in Lancashire and England
and between different groups within Lancashire. Partners in Lancashire received a
Comprehensive Area Assessment red flag for high deaths rates in deprived areas of
the county in the latest assessment.
The presentation will highlight the findings of comprehensive analysis undertaken on
the scale of health inequalities in Lancashire and will outline the action that partners
across Lancashire are taking together to address these health inequalities.
A twin tracked approach to red flag recovery is being adopted which includes a) the
development of a strategic framework for health equity to address the root causes of
health inequalities in Lancashire; and b) plans to address the biggest causes of
early death in Lancashire (alcohol related digestive disorders, infant mortality, heart
disease and stroke, cancer and accidents). The Lancashire Partnership has made
Health Inequalities one of its Big Ticket Issues and the presentation will outline how
the Big Ticket Issues approach is being applied to Health Inequalities.
Recommendation
The Adult Social Care and Health Overview and Scrutiny Committee is asked to:
1) Note the scale of health inequalities in Lancashire and the plans in place to
address create health equity
2) Consider how it will provide ongoing scrutiny to partnership performance on
addressing health inequalities
-2Background and Advice
The Lancashire PCTs and LCC established a Joint Health Unit in January 2009 to
provide public health expertise to LCC and to make partnership working between the
NHS and local government easier. The Lancashire Directors of Public Health,
supported by the Joint Health Unit, are developing a Strategic Framework for Health
Equity. This has included a comprehensive analysis of health inequalities in
Lancashire undertaken as part of the Lancashire Joint Strategic Needs Assessment
and will be informed by global evidence on health inequalities published by the World
Health Organisation in 2008.
This analysis of health inequalities in Lancashire identified the 10 health outcomes
for which the health gap between deprivation groups within Lancashire is the largest.
These are the goals of the strategic framework for health equity:
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Liver disease – those in the most deprived areas are 8 times more likely to
die prematurely than those in the least deprived areas.
Mental health and wellbeing – those in the most deprived areas are 6 times
more likely to experience extreme anxiety and depression as those in the
least deprived areas
Diabetes – those in the most deprived areas are 4 times more likely to die
prematurely than those in the least deprived areas.
Quality of life – those in the most deprived areas are 3 times more likely to
be experiencing extreme pain and discomfort than those in the least deprived
areas.
Infant mortality – babies in the most deprived areas are 3 times more likely
to die than those in the least deprived areas.
Coronary heart disease – those in the most deprived areas are 3 times more
likely to die prematurely than those in the least deprived areas.
Lung cancer – those in the most deprived areas are 3 times more likely to die
prematurely than those in the least deprived areas.
Stroke - those in the most deprived areas are 3 times more likely to die
prematurely than those in the least deprived areas.
Child health and wellbeing – those in the most deprived areas are 2.5 times
more likely to die than those in the least deprived areas.
Accidents – those in the most deprived areas are twice as likely to die as
those in the least deprived areas.
The evidence for the causal route for each of these inequalities in health outcomes
was analysed and 23 determinants of health were identified as the means of
addressing health inequalities in Lancashire. These were prioritised by stakeholders
at an event in November to engage partners from across the sub region in
developing the strategic framework. Two groups of priorities were identified: medium
to longer term priorities and those that would have an impact quickly if implemented.
Both groups are shown below.
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Medium to long term impact
Reduce unemployment and worklessness
Increase income and reduce child poverty
Strengthen communities (social capital)
Life long learning and skills development
Address alcohol misuse
Increase social support
Short term impact
Minimum unit price for alcohol
20 mph in residential areas
Reduce fuel poverty
Maximise the use of local authority
regulatory powers
The Strategic Framework will be launched in April 2010 and will address the root
causes of health inequalities in Lancashire.
Lancashire Partnership Executive has identified Health Inequalities as one of its four
Big Ticket Issues, to which a strategic delivery framework will be applied. Rather
than apply this process to the development of the whole strategic framework for
health equity, the scope of the Big Ticket Issue has been informed by the 'quick wins'
identified at the stakeholder event. The scope will focus on creating 'Healthy Streets':
aiming to create an environment in which people of all ages feel safe and inspired to
walk, play, cycle and socialise with neighbours. This will contribute both directly and
indirectly to most of the goals of the developing Strategic Framework for Heath
Equity (mental health and wellbeing, diabetes, quality of life, infant mortality,
coronary heart disease, stroke, children's health and wellbeing and accidents)
The Audit Commission awarded Lancashire a red flag for high death rates in
deprived areas in the 2009 Comprehensive Area Assessment. A twin tracked
approach to red flag recovery is being adopted which includes a) the development of
the strategic framework for health equity to address the root causes of health
inequalities in Lancashire; and b) plans to address the biggest causes of early death
in Lancashire (alcohol related digestive disorders, infant mortality, heart disease and
stroke, cancer and accidents).
Consultations
A Call to Action for Health Equity stakeholder event was undertaken on 6 th
November with 100 colleagues from across the Lancashire sub region. This group
identified priorities for the strategic framework.
Implications:
This item has the following implications, as indicated:
Risk management
Without robust actions in place to reduce health inequalities there is a risk that health
inequalities will increase and the CAA red flag will be retained, damaging the
reputation of the Lancashire Partnership and its constituent organisations,
particularity LCC, district councils and the PCTs.
-4-
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