1. Health and Wellbeing in times of Austerity Mary Hinds

2. Context  Life expectancy has improved – but inequalities remain a challenge  Lifestyle choices continue to cause harm  Young people disengaged  Older people isolated  A country of paradoxes - 3 in every 5 adults carries excess weight

3. Context  95,000 children – 22% - live in relative poverty  Rural older people often isolated with limited access to services  Migrant workers continue to have difficulties accessing services  Poor mental health effects 1 in 5

4. Give every child and young person the best start in life Parenting Support Programmes Breastfeeding Roots of Empathy Family Nurse Partnership Infant Mental Health Early intervention in areas of social complexity Early Years Transformation Programme

5. Ensure a decent standard of living Maximising Access in Rural Areas (MARA) Over 10,525 first visits and almost 7,000 follow up visits completed Levered £1,288,832 energy efficiency 3,783 households accessed Home Safety advice and equipment Welfare claims £534,526 so far 509 referrals to rural transpor

6. Older people Active Ageing Strategy Health and Wellbeing Improvement Programmes Models of Engagement Community Conversations Arts Festival

7. Sporting Organisations Sport NI, IFA, GAA, IRFU IFA e-learning Training for coaches mental health and wellbeing Youth player development GAA ‘Heads Up’ resource Mental health and sport – 55 governing bodies

8. Public Information Campaign

9. The Tests The Evidence Test The Economic Test The Moral Test The Legacy Test

10. The Evidence Test Austerity adversely affects mortality and morbidity rates Widens the inequalities gap Impacts adversely on mental and physical health with increases in suicide rates and excessive alcohol consumption

11. Who said this? Preventable disease should be looked upon as a social crime. Money would be better spent on maintaining health in infancy and childhood that in building hospitals to cure diseases(1894).

12. The Economic Test Five hours versus 8,755 5% of the population account for 84% of the costs Parenting and social emotional learning to prevent childhood behaviours problems have a 9:1 return on investment Alcohol misuse use costs us £900 million each year Obesity £400 million Smoking costs £164 to hospital services

13. The Moral Test The moral test of government is how it treats those at the dawn of life, children – those at the twilight of life, the aged – and those in the shadow of life, the sick, the poor, the disadvantaged and disabled. (Berwick 2011)

14. The Legacy Test A new conversation based on partnership Reassert values and vision A new conversation

15. The Challenge Do we have the vision for the future and the do we have the courage to make it happen? Do we have the policies to support equity from the start of life and social protection across its course? Do we have the systems in place to allow us to measure and understand the problems and access the impact? Do we have the political will and managerial skill to develop and harness a framework to reduce harm and variation, eradicate poverty and shift the balance of power, money and resource?

16. It is in our hands…