Health and Wellbeing Health Service Executive Healthy Ireland – The policy context for addressing health inequalities in Ireland Dr. Stephanie O’Keeffe,

Health and Wellbeing

Health Service Executive

Healthy Ireland – The policy context for addressing health inequalities in Ireland

Dr. Stephanie O’Keeffe, National Director, Health and Wellbeing

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Why: Health Check

EU goal +2 years of healthy life expectancy & reduction in health inequalitiesLife expectancy has improved but… obesity and predicted increases in chronic diseases and cancers stand in the wayPopulation GrowthPopulation Ageing +65s and +85s

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Health Check Half of people over 50 have one chronic disease, 11% have

more than one (TILDA). 20% to 40% increase expected in major chronic diseases by

2020. Three quarters of deaths in Ireland are due to three chronic

diseases – cancer, CVD and respiratory diseases, which are largely preventable.

Death rates: social class gradient 100-200% higher in lower SES. This pattern is true for cancers and CVD and markedly so for respiratory disease.

Context - Health Trends

Diet and nutrition Smoking Alcohol Physical Activity Hypertentsion Mental wellbeing Ageing population Chronic disease ↑ Healthcare sustainability €

International Strategic Context

Deviation of life expectancy at birth from average life expectancy by deprivation ranking

Social determinants of Health Inequalities 1

Life Expectancy by Social Class, Republic of Ireland, 2010

Social determinants of Health Inequalities 2

Low High

Educational inequality and obesity

Obesity and education level, females, Eurothine Study , 2009

Obesity: Systemic risks require systemic solutions

Healthy Ireland

Healthy IrelandA Framework for Improved Health and Wellbeing2013-2025

Vision: where everyone can enjoy physical and mental health and wellbeing to their full potential, where wellbeing is valued and supported at every level of society and is everyone’s responsibility.

Healthy Ireland Goals

Goal 1: Increase the proportion of people who are healthy at all stages of life

Goal 2: Reduce health inequalities Goal 3: Protect the public from threats to health and

wellbeing Goal 4: Create an environment where every individual

and sector of society can play their part in achieving a healthy Ireland

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Framework of Actions

Governance and PolicyPartnerships and Cross-Sectoral WorkingEmpowering People and CommunitiesHealth and Health ReformResearch and EvidenceMonitoring, Reporting and Evaluation

National Strategic Context

Improved health and wellbeing one of four pillars of reform in Future Health A Strategic Framework for Reform of the Health Service 2012-2015

Future Health and Healthy Ireland underline commitments at national level and service wide to reform our services and systems toward a renewed focus on chronic disease prevention and improved health and wellbeing

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Context: Health Service Reform

What works: learn from tobacco

Multiplier effects

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Health and Wellbeing: Priority Areas for Implementation

Reform H&W objectives embedded across health reform programmes

Capacity for system-wide implementation and reportingNational Leads and implementation plans for: child health and wellbeing, positive ageing, tobacco control, healthy eating and physical activity, alcohol misuse, sexual health

Health and Wellbeing: Priority Areas for Implementation

Models of care: Integrated clinical care programmes underpinned with prevention National Framework for self care in 2015 National model for brief intervention – every contact counts Consistent data capture on HIPE for lifestyle factors and interventions Generic model of care for chronic disease prevention and management

Health Service Staff improved levels of health and wellbeing

Site specific Healthy Ireland implementation plans: Hospital Groups & CHO

Key enablers Fit for purpose H&W Division Evidence and building a ‘Knowledge Management’ function

& capacity Communications strategy: patient and population

empowerment Partnership and strengthen frameworks and infrastructure

for delivery Capacity for sustaining the agenda nationally

Setting the groundwork for increased investment in prevention

healthandwellbeing@hse.ie

Thank you. Questions