CIH SE Conference Developing a link between health, housing & social care - 5 March 2014 pdfs/Presentations/South... · 2014-02-28 · CIH SE Conference – Developing a link between

CIH SE Conference – Developing a link between health, housing & social care - 5 March 2014

Healthy people, healthy places:

housing cause & contribution

Carl Petrokofsky

Specialist in Public Health, Health Equity & Impact Division

Public Health England

With especial acknowledgements to Gill Leng

Making Healthy Choices Easier Choices

Public Health England

• Expert national public health agency

• Statutory duty to protect health & address inequalities

• Evidence based expertise and advice

• Arrangements in place for preparing, planning &

responding to health protection concerns

• Works with national & local government, the NHS,

industry, academia, public & VCS

• Support to LAs, and CCGs

• Improvement led from within communities

• Legal duty to improve public’s health

• Evidence, knowledge, practical advice

• National action where it makes sense

Government • DH responsible to Parliament, with clear

line of sight through system

• CMO to continue to provide independent advice to Government

• Sets a context for wider policies impacting on health (eg NPPF)

Local authorities • New public health functions integrated

into their wider role, helping to tackle the wider social and economic determinants of health.

• Leading for improving health and coordinating locally for protecting health

• Promoting population health and wellbeing – role of Directors of Public Health

The New Public Health System: an

integrated whole system approach

NHS

• Delivering health care and tackling inequalities

• Making every contact count

• Specific public health interventions, such as cancer screening

Public Health England

• New, integrated national body

• Strengthened health protection systems

• Supporting the whole system through expertise, evidence and intelligence

Our priorities for 2013/14

1. Reducing preventable deaths

2. Reducing the burden of disease

3. Protecting the country’s health

4. Giving children and young

people the best start in life

5. Improving health in the

workplace

6. Promoting place-based public

health systems

7. Developing our own capacity and

capability

We want the same thing

Building a Healthy Future. November 13 2013

Why ‘Place’ is important for health

.

Causes of ill health

Housing impact on causes

PHE Health and Wellbeing priorities aim to reduce

the burden of disease attributable to 20 leading risk

factors, expressed as percentage of UK DALYS

Housing impact on early death

Housing contribution to outcomes

Smoking 10%

Diet/Exercise

10%

Alcohol use 5%

Poor sexual

health 5%

Health

Behaviours 30%

Education 10%

Employment

10%

Income 10%

Family/Social

Support 5%

Community

Safety 5%

Socioeconomic

Factors 40%

Access to care

10%

Quality of care

10%

Clinical Care

20%

Environmental

Quality 5%

Built

Environment 5%

Built Environment

10%

Contributors to health outcomes

We have to concentrate action on all

fronts

Nottinghamshire 2013

0

5

10

15

20

25

North East North West Yorkshireand TheHumber

EastMidlands

WestMidlands

East ofEngland

London South East South West

% H

ou

seh

old

s

Region

Overcrowded Households Percentage of Households with occupancy rating -1 and -2 or below

Source: 2011 Census

Aware of the challenges

• Austerity & welfare reform

• Affecting those already facing greatest inequalities

• Shrinking /changing services

• Rising homelessness

• Rise in use of temporary accommodation

• Increasing use of private rented sector

• Poorest housing

• Now biggest contributor to homelessness

• Ageing population

• Predominantly in owner occupied housing

Health Housing and Inequalities - June 11th 2013 16

Healthy People, Healthy Places

• The built and natural environment are major determinants of health and wellbeing.

• The design of the built environment, and access to the natural spaces, impacts on health and wellbeing

• Spatial planning and the design of homes, buildings, public spaces, neighbourhoods and transport routes can help promote or hinder other upstream health factors such as crime, physical activity and access to healthy food

• It also impacts on the wider social environment supporting or hindering community engagement.

Healthy People Healthy Places

Programme

Our vision for the future is that

everyone, wherever they live,

should be able to live, work and

play in a place that promotes

health and wellbeing; sustains

the development of supportive

and active communities; and

helps reduce health inequalities.

Our aim for the Healthy People

Healthy Places programme is to

support colleagues and promote

local and national policies to

achieve this wider vision.

Your input nationally

• National Health and Wellbeing Framework

• What does it need to say about housing?

• What would be your number 1 intervention?

• Healthy People Healthy Places programme

• What makes sense nationally?

• Support to the PHE ‘front door’?

• Support to the housing sector?

• Have you evidence?

• Do you have examples of ‘what works?’

Your input locally

• What are your local public health priorities?

• Have you considered what you:

• Contribute to health outcomes?

• For children to older people (life course)?

• Can you integrate improving health and

wellbeing into what you already do?

• As an organisation?

• Through your plans, policies and practice?

Conclusions

• Now that organisational transition is complete, we have unparalleled

opportunity to support a place based approach to health and

wellbeing improvement

• With their new public health responsibilities, LAs are now able to

bring together an approach which marries a focus on lifestyle and

behaviour combined with spatial planning and design to improve

health and wellbeing

• Now is the time to ‘reunite’ public health with it’s planning, housing,

and environmental health roots to support such change and achieve

better outcomes

• The new national focus on health and wellbeing through the

planning system follows and complements local government

leadership in this arena

• Success will require leadership, partnerships, evidence-informed

decision making, and a commitment to innovation and community

engagement

Working in

Partnership…

and Aligning Partners

to face in the same

direction

Carl Petrokofsky Specialist in Public Health

Health Equity and Impact

Division

[email protected]