1. Annual Report 2013/14

2. The causes of the causes  The social determinants of health underpin the stark inequalities in health in Camden and Islington.  For the less affluent, these inequalities mean poorer physical and mental health, poorer quality of life and an earlier death.  Reducing these inequalities is a matter of fairness and social justice. 2

3. Supporting people to have a healthy standard of living Areas of focus Health inequalities Helping people find good jobs & stay in work Education & health Healthier homes Widening the focus: next steps 3

4. 4 1: Health Inequalities

5. 5 Inequalities in life expectancy Camden 1: Health Inequalities Islington

6. 6  About half of Camden and Islington residents experience poorer health than the national average.  But there are differences in how patterns of health inequalities emerge locally, requiring different responses. –Camden: there are clear geographical patterns with residents living in the most deprived wards experiencing poorer health. –Islington: levels of deprivation are more widely spread and a whole borough approach will be required to tackle health inequalities, targeting different groups of people.  Focussing on only the most deprived and vulnerable residents, or those experiencing the largest inequalities, will not be enough because so many residents experience poor health. 1: Health Inequalities

7. 7 2: Helping people find good jobs & stay in work

8. 8 Camden Islington The importance of ‘good work’

9. 9  Health and Wellbeing Boards hold “Employment and Health” summits.  Public Health support existing Employment Boards and strengthen the focus on employment in the JSNAs and JHWSs.  Encourage organisations and businesses to become ‘health promoting workplaces’.  Integrate support for people after sick leave or those out of work with long term sickness and disability, and adopt a ‘health first’ approach.  Build on the employment support already available locally for people with a mental health condition to gain employment.  Employment should be a key strand of programmes focussed on giving children the ‘Best Start in Life’ given the negative impacts of unemployment on children’s lives. 2: Helping people find good jobs & stay in work Recommendations

10. 10 3: Healthier homes

11. 11 3: Healthier homes Homelessness Camden Islington

12. 12  Islington Health and Wellbeing Board should continue their work on housing and health following their summit.  Public Health will work with partners to strengthen the focus on housing throughout the JSNAs and the JHWSs.  Existing contacts with residents should be used to identify people in need of early housing or health interventions.  Do more work with housing associations and on housing estates to promote better health among residents using a range of interventions, working with residents themselves to improve their own health.  Increase understanding of why people with complex health needs or those with mental health problems are more at risk of homelessness.  Mitigate the impact of welfare changes.  Improve the quality of local private sector housing. 3: Healthier homes Recommendations

13. 13 4: Education and health

14. 14 4: Education and health Camden Islington Young people: GCSE attainment These charts show the percentage of students achieving 5 A*-C grade GCSEs compared against the London and England averages, any by selected demographic and economic factors.

15. 15  Both Camden and Islington’s Health and Wellbeing Boards continue to maximise opportunities to deliver improvements for children and young people, with a focus on continuing to improve educational attainment.  Both boroughs will continue Early Help and Early Intervention for children, young people and their families, including throughout the education setting.  School nursing teams should continue to deliver the 5-19 Healthy Child Programme.  All schools should work towards becoming a ‘Healthy School’.  Continue to support young people aged 16-18 years who are not in employment, education or training (NEET) to get a job, further education or training, and ensure adequate support for mental health problems in this group. 4: Education and health Recommendations

16. 16 5: Supporting people to have a healthy standard of living

17. 17 5: Supporting people to have a healthy standard of living Income inequalities Camden Islington

18. 18  Camden and Islington Councils should maintain their focus on tackling child poverty.  Ensure health professionals are maximising opportunities to refer residents to services which can help them have a healthy standard of living.  Health and Wellbeing Boards partners should continue to use their influence to encourage others to pay the London Living Wage  Promote a consistent approach to breakfast clubs.  Camden and Islington Councils should use their planning powers to support the development of ‘healthy high streets’.  Health partners should continue to support people to quit smoking. 5: Supporting people to have a healthy standard of living Recommendations

19. 19 6. Widening the focus: the next steps

20. 20 1.Doing more to address the social determinants of health, by making them everyone’s business 2.Prioritising our children and young people, to break the cycle of intergenerational health inequalities 3.Focussing on prevention and early intervention to provide better outcomes for residents and increase the sustainability of public services 4.Targeting the right people and the right places at the right scale to ensure that interventions are successful in reducing health inequalities 5.Working to address multiple underlying problems – families and communities affected by poor health are often challenged by multiple issues 6.Making best use of resources ensuring services and interventions are evidence-based, cost-effective & delivered to achieve maximum impact. 6: Widening the focus Recommendations

21. Thank you Report was produced by Public Health, with comment and input from other Local Authority directorates. 21

22. Questions or comments? David Clifford Public Health Information officer David.Clifford@islington.gov.uk 020 7527 1127 The report will be published on the Evidence Hub this week http://evidencehub.islington.gov.uk/wellbeing/Pages/default.aspx 22