Community-Centred Practice: Applying All Our Health

Information for front-line staff to adopt community-centred ways of working that help improves the health and wellbeing of the most marginalised communities | Public Health England

Evidence shows that community engagement interventions have a positive impact on a range of health outcomes across various conditions.  Recent NICE guidance on Community Engagement  signals the importance of working in partnership with local communities to plan, design, deliver and evaluate health and wellbeing initiatives.

Image source: www.gov.uk

For the NHS, the Five Year Forward View highlighted the need to ‘fully harness the renewable energy of communities’ as part of a greater emphasis on prevention. The community contribution of volunteers and residents active in their neighbourhoods is also important for local government.

From a public health perspective, involving people in volunteer and peer roles can help strengthen social networks and offers a means to access and connect with groups at risk of social exclusion.

This resource aims to help health professionals prevent ill health and promote wellbeing as part of their everyday practice. It includes guidance on:

  • adopting community-centred approaches in a professional practice
  • understanding local needs
  • measuring impact.

Full guidance: Community-Centred Practice: Applying All Our Health | Public Health England

Health matters: air pollution

A resource focusing on air pollution: sources, impacts and actions | Public Health England

Image source: www.gov.uk

Long-term exposure to air pollution reduces life expectancy by increasing deaths from cardiovascular and respiratory conditions, and from lung cancer. It is estimated that long-term exposure to air pollution in the UK has an annual effect equivalent to 28,000 to 36,000 deaths. We know that air pollution disproportionally impacts those who live in less affluent areas, broadening health inequalities.

This edition of Health matters focuses on air pollution and discusses how local authorities, supported by national policies, have an important role in assessing and improving local air quality – and how the cumulative effects of local action can be significant. It will be of particular value to local authority commissioners, directors of public health, environmental health officers, health and wellbeing boards, CCGs and health professionals.

Full resource: Health matters: air pollution

Study finds North-south divide in early deaths deepening

University of Liverpool| November 2018 | Study finds North-south divide in early deaths deepening

Data analysed as part of new research into the excess mortality and socioeconomic deprivation  reveals a profoundly concerning gap in mortality between the North and the South, especially in men.  The researchers involved from Keele, Liverpool, Manchester and York universities, looked into mortality rates in 5 most northerly government regions (Yorkshire and Humber, North East, North West, East Midlands West Midlands) and 5 most southerly government regions ((East of England, South Central, South West, South East, and London).  Using data from the Office of National Statistics (ONS) they aggregated and compared the northern and southern regions between the years 1981 and 2016. 

 

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The study found that:

• Accounting for age and sex, northerners aged 25-44 were 47% more likely to die from cardiovascular reasons, 109% more likely to die from alcohol misuse and 60% more likely from drug misuse, compared to southerners.

• London had the lowest mortality rates, with the North East having the highest, even after adjusting for age, sex and socio-economic deprivation.

• Suicide among men, especially at ages 30-34, and cancer deaths among women were also important factors.

• National cardiovascular death rates declined over the study period, though the North – South gap persists.

The study also revealed that, although there was little difference between early deaths in the North and the South in the 1990s, by 2016 a gap had opened up nonetheless.

(Source: University of Liverpool)

The study has now been published in the Lancet Health 

Abstract

Background

Since the mid-1990s, excess mortality has increased markedly for adults aged 25–44 years in the north compared with the south of England. We examined the underlying causes of this excess mortality and the contribution of socioeconomic deprivation.

Methods

Mortality data from the Office of National Statistics for adults aged 25–44 years were aggregated and compared between England’s five most northern versus five most southern government office regions between Jan 1, 1981, and Dec 31, 2016. Poisson regression models, adjusted for age and sex, were used to quantify excess mortality in the north compared with the south by underlying cause of death (accidents, alcohol related, cardiovascular disease and diabetes, drug related, suicide, cancer, and other causes). The role of socioeconomic deprivation, as measured by the 2015 Index of Multiple Deprivation, in explaining the excess and regional variability was also explored.

Findings

A mortality divide between the north and south appeared in the mid-1990s and rapidly expanded thereafter for deaths attributed to accidents, alcohol misuse, and drug misuse. In the 2014–16 period, the northern excess was incidence rate ratio (IRR) 1·47 for cardiovascular reasons, 2·09 for alcohol misuse, and 1·60 for drug misuse, across both men and women aged 25–44 years. National mortality rates for cardiovascular deaths declined over the study period but a longstanding gap between north and south persisted in 2016 in the north vs from 23·5 to 9·9 in the south. Between 2014 and 2016, estimated excess numbers of death in the north versus the south for those aged 25–44 years were 1881 for women and 3530 for men. Socioeconomic deprivation explained up to two-thirds of the excess mortality in the north. By 2016, in addition to the persistent north–south gap, mortality rates in London were lower than in all other regions, with IRRs ranging from IRR 1·13 for the East England to 1·22  for the North East, even after adjusting for deprivation.

Interpretation

Sharp relative rises in deaths from cardiovascular reasons, alcohol misuse and drug misuse in the north compared with the south seem to have created new health divisions between England’s regions. This gap might be due to exacerbation of existing social and health inequalities that have been experienced for many years. These divisions might suggest increasing psychological distress, despair, and risk taking among young and middle-aged adults, particularly outside of London.
Full reference: Kontopantelis, E., Buchan, I., Webb, R. T., Ashcroft, D. M., Mamas, M. A., & Doran, T. |2018| Disparities in mortality among 25–44-year-olds in England: a longitudinal, population-based study| The Lancet Public Health|DOI:https://doi.org/10.1016/S2468-2667(18)30177-4

 

 

Britain’s High Streets are getting unhealthier

New report finds Britain’s High Streets are getting unhealthier, with a clear link between deprived areas and unhealthy High Streets | Royal Society for Public Health

In 2015 the Royal Society for Public Health (RSPH) published the report ‘Health on the High Street’. The publication looked at the impact of different outlets on health and the potential cumulative effect these outlets could have on a local population. This report seeks to rerun the analysis to assess whether there has been much change in the last three years.

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Image source: http://www.rsph.org.uk

Based on the findings, the Royal Society for Public Health has ranked 70 of Britain’s major towns and cities by the impact of their high streets on the public’s health and wellbeing. The rankings are based on the prevalence of different types of businesses found in the towns’ main retail areas and rate Grimsby as having the unhealthiest high street, with Edinburgh coming out as the healthiest.

The top 10 “unhealthiest” British high streets were ranked as being in Grimsby; Walsall; Blackpool; Stoke-On-Trent; Sunderland; Northampton; Bolton; Wolverhampton; Huddersfield; and Bradford.

The top 10 “healthiest” British high streets were ranked as Edinburgh; Canterbury; Taunton; Shrewsbury; Cheltenham; York; Brighton & Hove; Eastbourne; Exeter; and Cambridge.

The RSPH said that average life expectancy for people living in areas with the top 10 healthiest high streets was two and a half years longer than for those in the 10 unhealthiest ranked areas.

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The report makes the following recommendations that aim to inject new life into our high streets:

  • HM Treasury to review how businesses are taxed to ensure that online businesses are not put at an unfair advantage compared to the high street
  • Facebook and Google to provide discounted advertising opportunities to local, independent health-promoting businesses
  • Local authorities to support meanwhile use of shops by making records on vacant commercial properties publically accessible
  • Vape shops to ensure all customers who smoke are aware of their local stop smoking service
  • Councils to set differential rent classes for tenants based on how health-promoting their business offer is
  • Business rates relief for businesses that try to improve the public’s health
  • Industry and all businesses selling food on the high street – cafés, pubs, fast food outlets, convenience stores, leisure centres – to reduce the calories in their products
  • The Ministry of Housing, Communities and Local Government (MHCLG) to provide local authorities with the power and support to restrict the opening of new betting shops and other unhealthy outlets where there are already clusters
  • Local authorities nationwide to introduce A5 planning restrictions within 400 metres of primary and secondary schools

Full report: Health on the High Street: Running on empty | RSPH

Related:

Keep Antibiotics Working campaign

Campaign returns and will run from Tuesday 23 October 2018 across England for 8 weeks and will be supported with advertising, partnerships with local pharmacies and GP surgeries, and social media activity | Public Health England

The ‘Keep Antibiotics Working’ campaign aims to educate the public about the risks of antibiotic resistance, urging people to always take healthcare professionals’ advice as to when they need antibiotics. Antibiotics are essential to treat serious bacterial infections, but they are frequently being used to treat illnesses such as coughs, earache and sore throats that can get better by themselves.  The campaign also provides effective self-care advice to help individuals and their families feel better if they are not prescribed antibiotics.

The campaign is part of a wider cross-Government strategy to help preserve antibiotics. The Government’s ‘UK Five Year Antimicrobial Resistance Strategy 2013 to 2018’ set out aims to improve the knowledge and understanding of AMR, conserve and steward the effectiveness of existing treatments, and stimulate the development of new antibiotics, diagnostics, and novel therapies.

Full detail at Public Health England

Public health grant funding gap

Taking our health for granted: plugging the public health grant funding gap | The Health Foundation 

This briefing paper assesses the extent of cuts to the public health grant since 2014/15 and projects the amount required per year to plug the funding gap that now exists is £3.2 billion. It highlights that cuts have not protected areas with the greatest deprivation or need. At a time of ongoing wider cuts to public services that directly impact on people’s health, and with the NHS under pressure, this approach risks widening health inequalities.

Full briefing: Taking our health for granted: plugging the public health grant funding gap

Additional link: Health Foundation press release

New support launched for disabled adults to improve health

Public Health England | October 2018 | New support launched for disabled adults to improve health

Public Health England (PHE) has produced an infographic for healthcare professionals and disabled adults. 

There are potentially around 3.5 million disabled adults at greater risk of poor health due to inactivity, and evidence shows they are twice as likely to be inactive to non-disabled people.

To address this, disabled people will be supported by new resources to help them get more active to improve their health.

PHE
Image source: gov.uk

80 per cent of disabled people report they would like to do more physical activity, highlighting continued barriers that prevent them from being active.

Concern around safety is often cited as a major barrier to disabled people undertaking physical activity, but a new review undertaken by PHE has shown that when performed at an appropriate level and intensity, this should not hinder them being more active and will lead to health benefits (Source: PHE).

See PHE for further information about the review

The infographic can be downloaded from PHE