1. The Health of Hertfordshire Raymond Jankowski Deputy Director of Public Health

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

4. The Life Course Approach Pre-conception and pregnancy Infancy (0-6 months) Early Years (6 months – 4/5 years) Primary school years Secondary school years Young adults (16-18 years) Working age adults Older adults Prevention & Treatment

5. 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

6. Smoking prevalence in Hertfordshire by age Pregnancy9-11 years old 15 years oldAdults GirlsBoysGirlsBoys 10.5%2%6%21%15%19.5% National targets 11% - - 12% 12% 18.5%

7. KeyIMD 3 to 8.9 9 to 14.9 15 to 20.9 21 to 26.9 27 and over Hertfordshire IMD 2010 by MSOA with district averages

8. KeyRange 0 to 10.9 11 to 12.9 13 to 14.9 15 to 16.9 17 to 18.9 19 and over GP-recorded Smoking prevalence by MSOA 2010-11

9. 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

10. 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

11. Obesity in Hertfordshire: challenges Prevalence % 4-5 year olds 10-11 year olds Adults 8-9%14-16%21.4%

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

13. KeyIMD 3 to 8.9 9 to 14.9 15 to 20.9 21 to 26.9 27 and over Hertfordshire IMD 2010 by MSOA with district averages

14. Prevalence of obesity in school age children (Year 6 aged 10-11 years) in MSOAs in Hertfordshire for 2009-10 KeyPrevalence of obesity 0 to 8.9% 9% to 13.9% 14% to 18.9% 19% to 23.9% 24% and over

15. 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

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

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