1. Mark Dooris Director, Healthy Settings Development Unit University of Central Lancashire mtdooris@uclan.ac.uk www.uclan.ac.uk/hsdu Investing for Health in North West England: Using the Healthy Settings Approach

2. Presentation Outline  Healthy Settings: Overview, Origins & History   Healthy Settings: Theory & Practice   North West Healthy Settings Development Unit &  Regional Health Promotion Planning  Challenges and Opportunities  - ‘fully developed’ approach within settings - - integrating different settings initiatives - - corporate citzenship agenda -

3. Healthy Settings Development Unit Aim & Functions To improve the health of the people of North West England & beyond by supporting & facilitating the development of the settings-based approach to health promotion & health development within the context of broad- based investment for health

4. Healthy Settings: Origins Settings Health for All 1977- Healthy Settings Ottawa Charter 1986 New public health – socio-ecological model Health not illness – ‘salutogenesis’

5. “Health is created & lived by people within the settings of their everyday life; where they learn, work, play & love.” WHO 1986 Ottawa Charter

6. Background Policy Context 1977 Health for All 2000 1986 Ottawa Charter 1991 Sundsvall Statement 1992 Agenda 21 1997 Jakarta Declaration 1998 ‘Settings for Health’ in WHO Glossary 1999 Health 21 – Target 13 ‘settings for health’ 2001 WHO European Office: Investment for Health & Development Settings-related Initiatives 1986 Healthy Cities Project 1988 Health Promoting Hospitals Project 1991 Health Promoting Schools Network 1992 Regions for Health Network 1995 Health in Prisons Project 1998 Health Promoting Universities Book Healthy Settings: International/European Timeline

7. Theory & Practice  What?   Why?   Where?   How?   Who? 

8. Settings as a Dimension of the Health Education Matrix Health Problem Population Group Setting

9. Aim: to integrate a commitment to health within culture, structures, processes & routine life of organisational & other settings Healthy Settings: What? “The place or social context in which people engage in daily activities in which environmental, organizational & personal factors interact to affect health & wellbeing. A setting is also where people actively use & shape the environment & thus create or solve problems relating to health. Settings can normally be identified as having physical boundaries, a range of people with defined roles & an organizational structure.” Settings for Health - WHO Health Promotion Glossary, 1998

10. Healthy Settings: Why (1)?   Health largely ‘produced’ outside of  Illness [health] services   Health improvement requires investment in  social systems in which people live their lives   Settings approach represents tangible way  of ‘investing for health’ at local level – health as asset for & outcome of development & productivity of organisations

11. Healthy Settings: Why? Leisure & Recreation ‘Health’& Social Care Criminal Justice Education Community Health Work/ Economy Illness Source: adapted from Grossman & Scala (1993) Ottawa Charter - strategies - - processes -

12. Universities & Colleges Health & Social Care Schools Prisons Workplaces Cities & Communities Other – eg clubs, homes Healthy Settings: Where?

13. Healthy Settings: Who? Teachers Students Governors Youth Service Health & Social Care Community Groups Healthy School Co-ordinator Non- Teaching Staff Parents/ Carers School Nurse Businesses Police Faith Organisations

14. Healthy Settings: How (1)? 3 focus areas or elements  Creating supportive/healthy living  & working environments  Integrating health development  into daily activities  Developing links with other settings &  wider community – ‘straddling settings’

15. Healthy Settings: How (2)? Values participation, equity, partnership, sustainability multidisciplinary ‘whole systems’ socio- ecological approach public health development agenda  institutional agenda/core business organisational development & change management  high visibility innovative project top-down political/ managerial commitment  bottom-up engagement & empowerment

16. North West England: Investment for Health

18. Healthy Settings Development Unit Aim & Functions To improve the health of the people of North West England & beyond by supporting & facilitating the development of the settings-based approach to health promotion & health development within the context of broad- based investment for health

19. Healthy Settings Development Unit Home New!! Conference 2003 Context Evidence History Theory Settings Topics Services: Events, Training & Consultancy Links Publications Newsletters Reports Contact Us Welcome to the website of the North West England Healthy Settings Development Unit Introduction The unit aims to support and facilitate the holistic and integrated development of healthy settings throughout England's North West. 'Health is created and lived by people within the settings of their everyday life; where they learn, work, play and love.' This website aims to provide a gateway for settings-related information. As well as pages on individual settings, it provides in-depth background and contextual information. The site is dynamic and developing, and includes details of useful resources and contacts as well as a host of helpful links to other sites of interest. What are healthy settings? At their simplest, settings such as schools and workplaces are convenient places for health interventions. However, healthy settings are about more than this, because they use whole systems thinking. This aims to integrate a commitment to health into the fabric of settings - within their cultures, structures, processes and routine life. More information on healthy settings... Background information on health, health promotion, health development and public health.. Healthy Settings Development Unit: Products

20. Healthy Settings Development Unit: Products

22. Healthy Settings Development Unit: Staff & Work Programmes   Director   Regional Healthy Workplace Co-ordinator   Regional Healthy Prisons Co-ordinator   National Health Promoting Hospitals Co-ordinator   Health Promoting University Co-ordinator   Research and Development Officer   Administrative Assistant + links to Healthy Schools, Colleges, Care Homes, Nightlife + commitment to integration with topic-based programmes (e.g. physical activity, transport, tobacco, mental health, violence and food)

23. Within settings – fully developed ‘whole system’ approach   connections between people, environments & behaviours    links between different health issues    personal and corporate citizenship – wider impacts  Between settings – ‘joined up’ approach   bridge the gaps    co-ordinate & integrate    maximise contribution to healthy city or community    horizontal & vertical networking  Evaluation & evidence   developing appropriate tools & investing in building evidence base  Conclusions: Implications, Opportunities & Challenges

24. Settings as springboards for corporate citizenship Potential for settings to use intra- and inter- organisational leverage to maximise their contribution to ethical practice and sustainable regeneration and development – linking local action to global agendas Conclusions: Implications, Opportunities & Challenges

25. Mark Dooris Director, Healthy Settings Development Unit University of Central Lancashire mtdooris@uclan.ac.uk www.uclan.ac.uk/hsdu Investing for Health in North West England: Using the Healthy Settings Approach