Agenda item

The Public Health Annual Report was a duty of the Director of Public Health. The report concentrated on health inequalities which were defined as variations in health not explained by biological factors such as age or sex. Poor health for people who live in certain areas was not inevitable and could be influenced by the choices and actions of individuals and organisations.  There was a clear economic case for tackling inequalities because of the cost of lost productivity as well as the health and social care costs. For individuals, the Marmot Report highlighted that nationally those on the lowest income lost around 17 years of disability free life and the compared to the highest. There was a gradient of health right across the population and the costs of dealing with poor health fell on taxpayers.

Overall health in Worcestershire was good and mortality from some of the common preventable conditions was low but there are differences between certain groups. The Report looked at the variations between groups and compared figures in the current report to the previous report of 2008 to examine progress, as well as considering local implementation of the recommendations of the Marmot report.

Gail Quinton raised a concern about the lack of visibility about understanding the health outcomes of young offenders. This would be looked at by the Integrated Commissioning Group.

Life expectancy across the County had increased across the population since 2008. Death rates had fallen across the population and to a greater extent in more deprived groups, which meant that health inequalities had narrowed by this measure.

The report confirmed how important it was to give children a good start in life because inequalities at birth persisted throughout life.  Babies from deprived areas were more likely to have mothers who were young, overweight or smoke and under unprepared for school.  Individuals' start in life had an effect on their future health and achievement throughout their lifetime.

Unemployment was lower in the county than the national average. Unemployment and low income had an effect on health outcomes. There were few low income households in Worcestershire and these tend to be concentrated in particular areas.

The areas with the best access to green space tended to be healthiest and have the highest levels of satisfaction with their area.

A small number of conditions were responsible for the majority of premature deaths and were all attributable to health related behaviours such as smoking, poor diet, physical inactivity and drinking too much alcohol.

In conclusion health inequalities had been reduced but persisted in some areas.  The public sector had an important role in continuing to reduce health inequalities but could not do so alone. A more sustainable asset based approach, drawing on the resources of individuals, families, communities and businesses would be necessary for continued improvement. The recommendations in the report were:

1.    Intensive ongoing support for vulnerable families,

2.    Intensive focus on early years development in priority areas,

3.    Employment opportunities in priority areas,

4.    Change to a place and asset-based approach to commissioning, and

5.    Strengthen and improve prevention of ill health.

In the following discussion it was clarified that:

·         The NHS used a formula to distribute money to CCGs according to need. Access to primary care services was typically poorer in the more deprived communities, with disproportionately high access to more expensive secondary care,

·         There needed to be more discussions with communities about their role in improving their own health, perhaps through Local Councillors and with the support of Healthwatch,

·         The Report gave some suggestions for investment, for example in prevention services for under 5s,

·         Households living in poverty were measured using indices of deprivation which looked at whether households were in receipt of certain benefits,

·         Information was not available to show if there had been a shift from people who were out of work and living in poverty to an increased number of people who were in work and living in poverty. However it might be possible to examine the relationship between employment and well-being in a future report,,

·         The Council had a responsibility for giving people information sout health lifestyles in a way they could understand, and individuals needed to take responsibility for taking action on them.

RESOLVED that the Health and Well-being Board:

a)    Noted the contents and endorsed the recommendations of the Annual Report;

b)    Asked Board Members to disseminate the key messages and recommendations within their own organisations and should seek further endorsement; and

c)    Requested that member agencies working through the Health Improvement Group and Children's Trust develop a single action plan to address health inequalities based on the recommendations and priorities for action in the Annual Report.