Agenda item

The Public Health Consultant summarised the main points of the Agenda report on health inequalities resulting from the Covid-19 pandemic, which highlighted the fact that the impacts had not been felt equally across the population, therefore increasing existing health inequalities.  For example, the risk of death had been raised across ethnicities and there had been an association between the risk of death and deprivation.

Long Covid was affecting sizeable numbers of people, estimated to be 20,000 across Worcestershire based on national levels.

The report also set out indirect impacts of Covid-19, including education, alcohol consumption, physical activity and mental health. Those in deprived areas had suffered more and experiences had drawn into focus knowledge around the need to focus on the least affluent.

The Cabinet Member with Responsibility (CMR) for Health and Health and Well-being highlighted the importance of addressing the long-term impacts of Covid-19.

The Chairman invited discussion and the following main points were made:

·         HOSC members agreed the report was very interesting in highlighting the themes which were emerging from the pandemic.

·         Regarding linking actions to outcomes on the work of Public Health in tackling health inequalities resulting from the pandemic, the CMR advised that this was being considered, along with how to inspire and enable people to make better decisions to improve their health outcomes – which could be reported back to the HOSC in future.

·         The Interim Director of Public Health highlighted the fact that every single line of the Plan for use of reserves accumulated during the pandemic, was focused on those most affected by Covid-19 – an example being extra health checks for young children, who may have missed standard checks.

·         The Officers explained that the impacts of the pandemic meant new ways of working were needed, for example working with the NHS on different structures in order to reach people.

·         The Officers acknowledged that some symptoms of Long Covid were very similar to other health conditions including Myalgic Encephalomyelitis (ME), however were confident there was awareness of this within the local health system and Public Health worked with the local Integrated Care Board (ICB) and Integrated Care System (ICS) to boost GP awareness. Specific services such as Long Covid clinics had been set up.

·         The Officers were not aware of specific data on the impact of Covid-19 on period poverty, however were working with schools and Worcestershire Children First (WCF) on sanitary products.

·         A HOSC member asked whether the push for people to get vaccinated (against COVID) had ceased, however was reassured that vaccination continued to be very important and that the offer remained very much open.

·         Language barriers were considered as part of public health work, with access to translators for most of the major languages spoken in the UK.

·         Regarding the mortality data presented, the Officers did not have data to hand regarding the various mutations of the Covid virus, although research continued internationally.

·         It was explained that the slower increase in mortality now was because it was more beneficial to a virus to survive, therefore it became less lethal to the population.

·         The impact of schools remaining open in the pandemic was complex to analyse since provision had been for children of key workers, as well as for disadvantaged children, which some families chose not to use.

·         Increases in child and adult obesity was a ‘wicked’ issue for Public Health and the ICS, with a whole agenda of related work and strategy.

·         Everyone agreed the impact on children’s education was concerning, and the Director referred to work to address this, in partnership with WCF, included trying to ensure that children were school ready, greater focus on speech and language, and increased mental health support.

·         The CMR pointed out that WCF Board meetings were public, and therefore open to HOSC members to raise questions about how the impact on education was being addressed.

·         The CMR agreed there was a general need to rebuild social confidence in society, and that anxiety about going into school or other environments may prevail for some, which would be looked at through national research.

·         A HOSC member spoke about her own Long Covid symptoms and suggested figures of those people affected could be far higher than recorded since she herself had not been in contact with specific services.

·         HOSC members enquired about the possible impact of long covid on the social care workforce. This was acknowledged as possible, with national research awaited and something which should be revisited. The CMR emphasised that everything possible was being done to attract people, retain them and importantly, to give them the recognition deserved for such important and rewarding work.

·         The CMR reassured HOSC members of the importance of health and well-being in the Council’s own work practices.

·         A HOSC Member spoke about the importance of equality and Worcester City Council’s recent introduction of a new Equality Strategy – and also referred to the Local Government association’s equality toolkit.

·         The Interim Director referred to the County Council’s equality toolkit and assessments and the considerable learning gained during the pandemic about engagement with hard-to-reach groups, for example from working with partners on targeted vaccinations.

·         Referring to national increases in alcohol-specific deaths and liver disease deaths, a HOSC member highlighted the importance of educating people about healthy eating and drinking after the pandemic, which the Officers agreed was important. The County’s Substance Misuse Service contract was aimed at quite a small proportion of people but the Public Health team tried to influence broader work locally, for example the impact of alcohol consumption. Overall directives about alcohol consumption were set at a national level.

·         The CMR had also followed up with the ICB on feedback from Cranstoun (which delivered the substance misuse contract) about the need for more care for individuals coming out of initial support.

·         It was acknowledged that the requirement to exercise alone during periods of the pandemic may have been a factor in decreased activity levels, and the CMR said that an important message was that exercise could be little things which did not cost much, for example 5 minutes skipping a day increased both fitness and bone density.

The Chairman thanked the CMR and Officers for the informative discussion.