Public Health challenges in Hertfordshire Raymond Jankowski Deputy Director of Public Health

Public Health The art and science of prolonging life, preventing disease and promoting health through the organised efforts of society

3 domains of Public health Health improvement Health protection Health care

Commissioning Health and Wellbeing for Hertfordshire

Public Health Challenges Tobacco control Obesity Alcohol misuse Children and young people realising their full potential Mental health and wellbeing Supporting older people to live independent lives Health inequalities Quality Innovation Productivity Prevention (QiPP) Climate change Lifelong learning

Tobacco control: the challenge Increase referrals to Hertfordshire smoking cessation services Reduce number of people starting smoking Effective communication and social marketing Reduce supply of cheap and illicit tobacco Reduce health inequalities

Smoking prevalence in Hertfordshire by age Girls 9-11 yrs Boys 9-11 yrs Girls 15 yrs Boys 15 yrs AdultsPregnancy 2%6%21%15%19.5%10.5% National target % 12% 18.5%11%

KeyIMD 3 to to to to and over Hertfordshire IMD 2010 by MSOA with district averages

KeyRange 0 to to to to to and over GP-recorded Smoking prevalence by MSOA

Estimated NHS and wider economy costs of tobacco control in Hertfordshire NHS - £54M Wider economy -£275M – Cleaning up cigarette butts - £5.8M – Smoke related fires - £8.7M

Summary Build on a strong Hertfordshire Tobacco Control Alliance, to reduce smoking prevalence by: Supporting smokers in priority groups to quit Continuing to support actions to reduce supply of illicit tobacco Reducing the uptake of smoking among young people

Obesity in Hertfordshire: challenges Prevalence % 4-5 year olds year olds Adults 8-9%14-16%21.4%

Estimated NHS and economic costs in Hertfordshire NHSWider economy 2007£84M£320M 2050£174M£1000M

KeyIMD 3 to to to to and over Hertfordshire IMD 2010 by MSOA with district averages

Prevalence of obesity in school age children (Year 6 aged years) in MSOAs in Hertfordshire for KeyPrevalence of obesity 0 to 8.9% 9% to 13.9% 14% to 18.9% 19% to 23.9% 24% and over

Reducing Obesogenic environment Individuals, Families, Communities  Physical activity  Healthy eating and sensible drinking Motivation Self esteem Cost and availability of leisure facilities Availability of green space Cycle lanes Pedestrian friendly Community safety Healthy workplace Motivation Self esteem Cost of healthy eating Shopping skills Cooking skills Availability of fresh produce Advertising Healthy workplace

NHSWider economy % NHS/wider economy Tobacco control £54M£275M20% Obesity£84M£320M26% Alcohol£54M£400M13.5% NHS versus wider economy costs in Hertfordshire

Challenges in older age Falls Dementia Social isolation Intermediate care End of Life Influenza Fuel poverty