Launching the Middlesbrough Health and Wellbeing Strategy Edward Kunonga Director of Public Health Middlesbrough Borough Council and NHS Middlesbrough Launching the Middlesbrough Health and Wellbeing Strategy Launching the Middlesbrough Health and Wellbeing Strategy 1

Public health domains and the role of the public health team S. Griffiths, Jewell T and Donnelly P (2005). Public health in practice: the three domains of public health. Public Health Volume 119, Issue 10, October 2005, Pages 907–913

Examples of current work Health Improvement developing a strategy for improving health and reducing health inequalities Tackling the wider determinants of health Health Protection Ensuring there is a coordinated local multi-agency health protection plan to protect the local population: includes communicable disease control, EPRR, major incident planning, seasonal plans (winter and heat wave) Liaising and advising on environmental threats including pollution, noise and contaminated land Health services public health Prevention and early detection of disease – finding the missing thousands (cancer and long term conditions) Supporting the commissioning of high quality, equitable health and social care services

Models of Practice for DPH roles – Elson the expert the critical friend the adviser the provider the catalyst the community advocate and leader

Key public health issues in Middlesbrough Health inequalities – social class, ethnicity, disability, mental health status Lower health outcomes for the level of investment Lifestyle risk factors – obesity, alcohol, teenage pregnancy Rising healthcare costs and increased demand Research and technology – new treatments Welfare reforms and the economic recession Aging population – with complex co-morbidities Re-emerging and new infections People living in the poorest areas will, on average, die 7 years earlier than people living in richer areas spend up to 17 more years living with poor health. have higher rates of mental illness; of harm from alcohol, drugs and smoking; and of childhood emotional and behavioural problems. Although infectious diseases now account for only 1 in 50 deaths, rates of tuberculosis and sexually transmitted infections (STIs) are rising and pandemic flu is still a threat. Healthy Lives healthy People – D0H 2010

Marmot review slides 6

Middlesbrough Ormesby Bank 74 75 72 77 79 86 82 84 Life expectancy Pallister 74 75 Park End 72 77 Marton 79 86 Nunthorpe 82 84 The gradient of inequalities in health Life expectancy reduces by 2 years for every mile from suburb to centre

Access to health and social care services Inequalities in life expectancy, deaths and disease Access to health and social care services Treatment, early interventions, prevention, social care services Lifestyle and behaviour risk factors Smoking, obesity, alcohol, physical activity, nutrition Social causes Poverty, employment, housing, crime, occupation and education, welfare reforms and the recession 8

Social determinants of health Dahlgren and whitehead model

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