1. Improving Health through Healthy Schools Cathy Wynne Regional Public Health Specialist NW DHSC North Lancashire Healthy Schools Programme Launch April 2002

2. Saving lives: Our Healthier Nation The Goals Improve health To improve the health of the population as a whole by increasing the length of people’s lives and the number of years people spend free from illness Narrow the health gap To improve the health of the worst off in society and to narrow the health gap

3. The role of education ‘ Education is vital to health. People with low levels of educational achievement are more likely to have poor health as adults…By improving education for all we will tackle one of the main causes of inequality in health’ (Department of Health 1999, Saving Lives Our Healthier Nation)

4. The widening health gap Death ratios by social class Social class Professional Unskilled Average for working age men Year 1930-321959-631991-93 Log scale 160 100 50 25 1.2 times greater 2.9 times greater England & Wales

5. Inequality: social class Excess death rates for men in non-professional classes England & Wales 1991-93 280 300 426 493 492 806 I - Professional II - Managerial IIIN - Skilled (non-manual) IIIM - Skilled (manual) IV - Partly Skilled V - Unskilled European standardized mortality ratio per 100,000 population for men aged 20 - 64

6. Inequalities in healthy life expectancy 17% of social class 1 men aged 45 - 64 report limiting longstanding illness 48% of social class 5 men aged 45-64 report limiting longstanding illness

7. Health inequalities: geographical variations A boy in Manchester can expect to live over 7 years less than a boy in Barnet A girl in Manchester can expect to live 6 years less than a girl in Kensington, Chelsea and Westminster

8. Health Inequalities – the Policy Context 1998 The Acheson Report 1999 Saving Lives: Our Healthier Nation 2000 The NHS Plan –Inequalities and Public Health Task Force –2 National Health Inequalities Targets 2002 Cross-cutting Spending Review

9. Health inequalities: Six priority areas for action Providing a sure foundation through a healthy pregnancy and early childhood Improving opportunity for children and young people Tackling the major killers – CHD and cancer Strengthening disadvantaged communities Tackling the wider determinants of health Improving NHS Primary Care Services

10. What is health? WHO defines health as “ a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity”

11. Health Determinants

12. Mortality Trends England and Wales 1841 - 1985

13. World Bank Review 1993 Health Care Spending and Population Health Status “At any level of (population) income and education, higher health spending should yield better health, all else being equal. But there is no evidence of such a relation” World Bank Investment for Health Report (1993)

14. Causes of Premature Death & Disability (and thus health sector costs) 10% due to inadequate access to health care 20% genetic 20% environmental 50% behavioural & lifestyle US Surgeon General (1996)

17. Health Promotion is the process of enabling people to increase control over and improve their health. Health Promotion is about making healthy choices the easy choices

18. “Health is created and lived by people within the settings of their everyday life: where they learn, work, play and love.” Ottawa charter, WHO, 1986

19. Health promoting settings Healthy schools Healthy workplaces Healthy prisons Healthy hospitals Healthy colleges Healthy ………..

20. Addressing the determinants of health in 1866 “ Building more children's hospitals is not the proper remedy for infantile mortality and sickness - the true remedy lies in improving children's homes” In 1866 Florence Nightingale was asked to open the new children's hospital in Manchester. Brierly JK (1970) A Natural History of Man. Heinemann

21. Health promotion IN a setting Problem-specific focus External or ‘internal-specialist’ impetus Lack of impact on the organisation as a whole

22. 3 elements of a health-promoting setting Creating a healthy living and working environment for clients and staff Integrating health promotion and health education into the daily activities Outreach into the community

23. A health-promoting setting Becomes engaged in an ongoing process of reviewing its activities and functions in relation to their health impact Is committed to integrating health issues into its routine structures and functions to create an environment conducive to health

24. Healthy Schools – who benefits? Students Staff Parents Community

25. Healthy Schools support….. Safer routes to school Fruit in schools 5 a day Smoking policy Schools Nutrition Action Circle time Emotional literacy Staff support

26. Why Healthy Schools? Reach whole population Staff/parents/students/community Address inequalities Influence behaviour/lifestyle ‘Virtuous circle’

27. Healthier children more ready to learn Education improves life-chances and thereby health Win – Win for education and health – and for children!

29. Improving Health through Healthy Schools Cathy Wynne Regional Public Health Specialist NW DHSC North Lancashire Healthy Schools Programme Launch April 2002