FHWA Health and Health Inequalities Dr Gina Radford DPH

SMRs, Fife, 1995 - 2004

All cause mortality rate per 100000 population aged under 65, by interzone, Fife and Scotland, 2006

Determinants of health

ROA areas 20% most deprived population 20% least deprived population Fife All cause mortality rate per 10000 population under 65 (2005) 44.7 42.4 16.7 31 Hospital admissions for alcohol misuse rate per 10000 population (2002-2004) 95.9 89.7 19.2 48.5 Percentage of women smoking in pregnancy (2002-2004) 47.2 46.8 7.8 28.5 Percentage of working age population claiming Job Seekers Allowance (2005) 7.5 6.9 1.1 3.4 Percentage of working age population in receipt of Incapacity Benefit, Severe Disablement Allowance or Compulsory New Deal (2005) 18.2 17.1 2.9 9.1

Reducing Health Inequalities Health varies in Fife in relation to Socio-economic status Gender Ethnicity Place of residence Other inequalities

Percentage of S4 children attaining English and Maths at SCQF level 3 and above, 2006 Looked after children 40% Fife 89% Scotland 91.3% Risk factors for teenage pregnancy Poor attendance rates and dislike of school Poor educational attainment

Feeling like they belong somewhere, like they’re living their life.

More likely to reduce inequalities Improving accessibility of services Prioritising disadvantaged groups Offering intensive support Starting young

Disadvantaged groups tend : to be harder to reach to find it harder to change behaviour to receive less benefit from lifestyle change or access to services interventions with more disadvantaged groups may need to be much more intensive and targeted than might be appropriate for more advantaged groups: information based approaches such as food labelling, pamphlets in doctors’ surgeries, and mass media campaigns, or those which require people to take the initiative to sign up for, may be less effective among more disadvantaged groups

An intervention which, in general, works (e. g An intervention which, in general, works (e.g. dental health education) might have no effect on health inequalities if all SES groups benefit equally increase health inequalities if the rich benefit more reduce health inequalities if the poor benefit more

Less likely to reduce inequalities Information based campaigns Written materials Campaigns reliant on people taking the initiative to opt in Campaigns/messages designed for the whole population Whole school health education approaches

Young people are the future generation so we need to help them before they become useless to society. What use is a twenty-five year old man with no qualifications, no job and messes around with alcohol and drugs?

Priority areas for Fairer Scotland Fund Health Inequalities funding – the context SOA Community Plan Fairer Fife Framework FSF principles JHIP Equally Well

What people told us Fairer Fife Framework Action Areas Priority 1 Targeting resources to people living in the most disadvantaged life circumstances 17 8 Improving mental health and emotional well-being 4 10 Increasing opportunities for people to have a healthier lifestyle in relation to where they live, work and spend their time 3 2 Increasing community involvement in the planning and delivery of health improvement work – Improving access to services and support that impact on peoples health and well-being –

What people told us Equally well priority areas Priority 1 Priority 2 Children, particularly in the early years 11 3 “Killer diseases” such as heart disease, cancer, diabetes (and associated risk factors such as smoking, obesity etc) 12 2 Mental health and wellbeing 4 The harm caused by drugs, alcohol and violence 5

What people told us People living in most disadvantaged areas in Fife 19 People represented by one of the six equality strands 2 Race 4 Gender Disability 6 Age Religion/belief 3 Sexuality Other e.g. people addicted to drugs/alcohol; long-term unemployed Early Years and vulnerable young people Homelessness and housing issues People with mental health issues Others 16

What people told us Other issues Integrated approaches Improving access to services Early intervention across lifestages Clusters of disadvantage/identified families not geographical areas

5 areas emerged Vulnerable families Mental health & wellbeing Homelessness & housing issues Alcohol Disadvantaged life circumstances

Seasons Greetings

Consensus Voting You have three votes Vote once for each of your top three priorities from the list Your votes are worth 3 points, 2 points and 1 point Use more points for your higher priority List Disadvantage (Areas and/or Individual Circumstances) Mental health and wellbeing  Alcohol  Vulnerable families Homelessness and housing issues