1. Two years on – achievements so far, opportunities for the future Haringey’s Health and Wellbeing Strategy refresh July 2014

2. 2 Purpose of this session Look at the highs and the lows since 2012 Explore the key issues, challenges and opportunities for the future Determine a strategy fit for the future Where next?

3. 3 A reminder: Vision for 2012-2015: A Healthier Haringey We will reduce health inequalities through working with communities and residents to improve opportunities for adults and children to enjoy a healthy, safe and fulfilling life

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5. 5 Poor construction Lack of fire safety Overcrowding Small rooms Noise Anti-social behaviour Insufficient local amenities Poorhealth How does the lived experience affect health and wellbeing in Haringey?

6. 6 Reduce infant mortality Reduce teenage pregnancy Reduce childhood obesity School readiness OUTCOME 1: EVERY CHILD HAS THE BEST START IN LIFE PRIORITIES:

7. 7 Summary of highs and lows Reduction in teenage pregnancy (still high cf London / natl) Reduction in infant mortality (still high cf London / natl) 1 in 3 children live in poverty:  10,000 lone parent households (34% cf. 28% London)  1 in 4 live in household with no working adult (23% cf. 18%) Low school readiness; high level of children with additional needs and disabilities High first time entrance to youth justice cf. London / natl Childhood obesity is high cf London / natl; tooth decay has worsened (poor cf London & nat.)

8. 8 Ongoing concerns: Not all equal Prevalence of overweight or obesity in year 6 (2013) Note that the Highgate sample is relatively small (41 pupils) and may not be representative of the ward population * Crouch End 20% Seven Sisters 56% * Source: Public Health England, PHOF (Accurate as at May 2014)

9. 9 Reduce smoking Increase physical activity Reduce alcohol misuse Reduce early death from cardiovascular disease and cancer Support people with long term conditions to live a healthier life OUTCOME 2: REDUCING THE GAP IN LIFE EXPECTANCY PRIORITIES:

10. 10 Summary of highs and lows Life expectancy  is improving generally, esp. for men  men die younger than women (largely due to high CVD, though early CVD death continues to decrease)  the gap for men and women has remained constant over the last ten years (about 8 years) ‘Healthy life expectancy’  on average, women live the last 20 yrs of life in poor health  worse cf London and national  no. of people with dementia and LTC is increasing

11. 11 Main risk factors for these diseases - Smoking (1 in 5 of all deaths are related to smoking) - Diet - Physical inactivity - Alcohol use Main causes of early death - Cardiovascular disease (CVD) - Cancer - Respiratory disease Reasons for the gap in life expectancy

12. 12 79.4 years 83.8 years Life expectancy v healthy life expectancy Source: PHE 2014 Public Health Outcome Framework Healthy life expectancy 60 years Average life expectancy On average, men and women both have poor health from the age of 60

13. 13 Ongoing concerns: alcohol-related harm is rising

14. 14 Supporting people to live fulfilling lives 1 in 13 residents are unpaid carers  own health and wellbeing is an issue with 1 in 3 saying they cannot look after themselves  58% females  over 4000 have up to 50 hours of unpaid care work a week  our carers are younger than London’s average

15. 15 Promote the emotional wellbeing of children and young people Support independent living Address common mental health problems among adults Support people with severe and enduring mental health problems Increase the number of drug users completing treatment successfully OUTCOME 3: IMPROVED MENTAL HEALTH AND WELLBEING PRIORITIES:

16. 16 Summary of highs and lows Recorded crime is down by 40% 16 Green Flag parks and 4 Community Green Flag gardens High level of temporary accommodation and homelessness High numbers of children have behavioural problems Many people suffer from anxiety and depression, and autism, without help or support from services Severe mental illness:  significantly high especially in the east  High % have poor physical health and LTC  Low % in employment or settled accommodation Over 30% of offenders have ‘mental health problems’

17. 17 Higher likelihood of those with schizophrenia living in the east Residential care homes for people with mental health issues more concentrated in the east Ongoing concerns: Example: mental health and links to housing

18. 18 Emerging issues Unhealthy relationships (including child sexual exploitation, domestic violence, high sexually transmitted infections) Transition of young people into adulthood JSNA online at: http://www.haringey.gov.uk/JSNAhttp://www.haringey.gov.uk/JSNA

19. 19 Making a difference? eg: Tackling smoking 1. Population level interventions Enforcement of national legislation on smoke free work places Responsible retailers scheme (tobacco and alcohol) 2. Interventions through communities Healthy Schools programme Peer health champions 3. Intervention through services Smoking Cessation Service Adapted from C. Bentley, 2007

20. 20 Funding health and wellbeing How much money are we all investing in health and wellbeing across different agencies (CCG, LBH, Police, voluntary sector...)? How can we make sure we target and invest wisely in effective and relevant support?

21. 21 Next steps This session is a conversation starter. The next steps are: to evaluate feedback from these early meetings move into a consultation phase publish a refreshed Health and Wellbeing Strategy for 2015-2018 Where next?