What is health Session 3 Health in SEA

Older people Dog excrement Positive health Heart Disease Bad Housing Blood Pressure Teenage Pregnancy MeningitisDrugsAccidentsFeeling goodHIV/AIDSDiabetesSmokingFood Safety Waiting Lists ParentingSuicide Water Fluoridation Exercise Family

Exercise: What does health mean? – Which factors are most important for health? For you For your town/city/county – How can this factor be acted upon to improve health? – Can you turn this into a Health Objective for an SEA? – Discuss this as a group and pick 3 to share

Definition of Health WHO Constitution 1948 ‘ A state of complete physical, mental and social well-being and not merely the absence of disease and infirmity’

Definition of Health ‘A state in which people are able to work towards attaining their realistic chosen and biologic potentials’ Seedhouse (1986) Health: the foundations for achievement Chichester. John Wiley

‘Health is the person’s capacity to function to the greatest capacity, to maintain a balance appropriate to age and social needs; to be reasonably free of gross dissatisfaction, discomfort, disease or disability; and to behave in ways that promote survival as well as self-fulfilment or enjoyment’ (Blum 1972) (Blum H.L. 1972, p213 in Goldsmith S.B. (1972) The status of Health Status Indicators. Health Service Reports, 87(3), ) Definition of Health

Understanding Health Variety of definitions and interpretations Complex and contested concept Need to extend boundaries beyond consideration of the health service and ill health Health vs Health and wellbeing?

General socioeconomic, cultural and environmental conditions Living and working conditions Social and community influences Individual lifestyle factors Age, sex & hereditary factors

Statements of Health Inequalities People living in the most deprived neighbourhoods will:  die on average 7 yrs earlier than those in the richest neighbourhoods  spend more of their lives feeling unwell Those living in the greenest areas have longer life expectancy Those with no or poor quality employment have a higher risk of poor physical and mental health Those with low perceived social support have lower health status measures

Health Inequalities Douglas Black report on inequalities in Health, 1980 Paperback edited version published 1982 Growing concern for major social causes of ill health and inequalities in health

Published 1998 Call for action on a broad front to tackle health inequalities Close collaboration with Local Authorities and other sectors to promote health and prevent disease Basis for other policy documents

Strategic review of Health Inequalities in England post 2010 Strategies to reduce health inequalities in England Action on social determinants of health Local Authorities have a key role

Marmot Review Policy Objective E Create and develop healthy and sustainable places and communities sustainable neighbourhoods sustainable food production active transport zero carbon houses Reducing health inequalities compatible with climate change mitigation, health benefits from: Integrate planning, transport, housing, environmental and health policies to address the social determinants of health

Health inequalities Government policy is to reduce health inequalities Logic of this is that where negative impacts are unavoidable they should fall on populations most able to bear them But is this politically acceptable?

Screening questions Will the proposal: Have an impact on the physical or mental health and well being of the whole population or of particular sub groups in the population? Affect individual ability to improve their own health and wellbeing? Proposal produce a change in demand for or access to health and social care services? Have an impact on social, economic or environmental conditions that could affect health? Have an impact on global health? One or more positive response indicates need for HIA

Watch Out For Health Checklist Housing Access to public services Opportunities for physical activity Air quality, noise, neighbourhood activity Social cohesion and social capital Accessibility and transport Crime reduction and community safety Access to healthy food Access to work Resource minimisation Climate change Does the proposal provide opportunities for local businesses? Yes No N/A For example