1. 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

2. 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

3. 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

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

5. 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

6. Marmot review slides 6

7. 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

8. 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

9. Social determinants of health
Dahlgren and whitehead model

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