Post on 16-Jul-2020
University of Hertfordshire & Hertfordshire County Council MasterclassPublic Health: what next?
Wednesday 12th June 2019
#hertsphconnect
Public Health: what next?Wednesday 12th June 2019
ChairCouncillor Tim Hutchings
Executive Member for the Public Health and Prevention Portfolio, Hertfordshire County Council
Contributors
Professor Jim McManusDirector of Public Health, Hertfordshire County Council
Professor Wendy WillsDirector, Centre for Research in Public Health and Community Care [CRIPACC], University of Hertfordshire
Dr Zoe AslanpourAssociate Dean Community, International and Partnership [LMS], University of Hertfordshire
Consultant in Public Health
Ciceley ScarboroughProject Manager, Public Health, Hertfordshire County Council
Presentations followed by
Facilitated roundtable discussions
#hertsphconnect
Public Health: what next?Wednesday 12th June 2019
Professor Jim McManus
Director of Public HealthHertfordshire County Council
Public Health Futures
#hertsphconnect
www.hertfordshire.gov.uk
Biomedical Psychosocial
SocialStructural and Environmental
“Knowing” an issue in its multiple dimensions
Complexifying Challenges, Solutions
and Knowledge is essential
www.hertfordshire.gov.uk
1. Good Start in Life
2. Good Education
3. Meaningful and fair employment
4. Healthy Place
5. Healthy Housing
6. Balance – Physical, Psychological, Spiritual, Interpersonal
7. Sustainable Environment
8. Healthy Living made easy and second nature
9. Connect, Be Active
10.Meaning, Purpose and Hope
The Building blocks of good health
www.hertfordshire.gov.uk
Persistent Challenges
Variation in Life Expectancy (7.2 years men, 5.4 women)
Untoward Variation in Care
Economic Inactivity and Worklessness
Preventable Mental Ill Health
A system which can’t cope with complex problems
Preventable Disability
Not seeing Human Person as Unity across Life
www.hertfordshire.gov.uk
Rank Cause % of YLDs
1 High BMI 6.58
2 Smoking 5.38
3 High fasting plasma glucose 5.16
4 Alcohol use 2.22
5 High systolic blood pressure 2.18
6 Drug use 2.16
7 Occupational ergonomic factors 2.15
8 Ambient particulate matter pollution 1.40
9 Diet low in whole grains 1.30
10 Low bone mineral density 1.05
Source: Global Burden of Disease Study, 2017 estimates
Burden of Disease Years Lived with
Disability
www.hertfordshire.gov.uk
DPH Report 2018-19
www.hertfordshire.gov.uk
• The prevalence of mental disorder in 5-15 year olds rose from 9.7% in 1999 and 10.1% in 2004, to 11.2% in 2017 (equating to c.18,600 children and young people in Hertfordshire).
• About one in seven (14.4%) 11-16 year olds have a mental disorder (equating to c.12,065 children and young people in Hertfordshire).
• Looked-after children generally have greater mental health needs than other young people.
• 28% of boys and 42% of secondary aged girls in Hertfordshire in 2018 said that they worried ‘quite a lot’ or ‘a lot’ about their own mental health.
Mental Health and Young People
www.hertfordshire.gov.uk
Mental Health JSNA, 2015
www.hertfordshire.gov.uk
Total Population
1,525,147
Mostly Well
1,042,500, (68%)
People with Long
Term Conditions
299,630, (21%)
People with complex
needs
170,468
(11%) - 43% of total
spend
Age 70+
198,269 (13%)
population
47,700 (24%) 231,601 (42%) 79,479 (34%)
Adults 16-69
1,006,597 (13%)
Population
694,800 (69%) 223,421 (22%) 88,376 (9%)
Children & Young
People 0-15
320,280 (21%)
population
300,100 (94%) 21,219 (5%) 2,619 (1%)
HWE STP Population Health Management
Population Health Profile – The Challenge
www.hertfordshire.gov.uk
• Prevention Vision
• NHS Long Term Plan
• Green Paper on Prevention
• Social Care Green Paper (2 years and counting)
• Clean Air Strategy
• Serious Violence Strategy
• Spending Review – Errr….
– Wanting to get into Genomics, Technology and Predictive Prevention (whatever that is)
The National Policy Agenda
www.hertfordshire.gov.uk
Govt says the Green Paper will…
We need to push heavily on this. It’s the weakest section of the Green Paper
www.hertfordshire.gov.uk
DHSC Slides
www.hertfordshire.gov.uk
DHSC Slides
www.hertfordshire.gov.uk
Problems• Nothing on wider determinants or systems
• Very “health” focused
• Trying to be cross-govt but not really
• Simplistic lifestyle narratives
• Very focused on narrative of personal responsibility
• Role of social sciences not articulated
• Lack of coherent lifecourse vision
• Very focused on clinical outcomes
• What about crime, work, sustainability, growth, air quality?
www.hertfordshire.gov.uk
DHSC Slides
www.hertfordshire.gov.uk
DHSC Slides
www.hertfordshire.gov.uk
What might be the future?• A Public Health which is committed to Human
Flourishing
• A Public Health which can
– Hold individual and social in dynamic tension
– Understand complexity and address it on multiple levels
– Understand and use systems approaches
– Think and act from wider determinants to clinical and back again
– That thinks Lifecourse
– That thinks of the human person as Unity
www.hertfordshire.gov.uk
• Population Health
– Wider Determinants
– Sustainability
• Population Health Management
• No Health Without Mental Health
• Complexifying
• Systems Approaches
• Better use of Data and Informatics
Opportunities
www.hertfordshire.gov.uk
A Public Health
Wales take
www.hertfordshire.gov.uk
Determinants
www.hertfordshire.gov.uk
MOSTLY HEALTHY DIAGNOSED LONG TERM CONDITION
COMPLEX NEEDSHigh cost
Low cost
Actions:
• have proactive, meaningful, personalised care plans
• prevent people reaching crisis points
• reduce need for emergency care
Achievable curve?
Existing curve
Actions:
• reduce risk and keep people well
• prevent need from arising
• meet urgent care needs when they arise
Actions:
• intervene early to reduce or delay need
• reduce need for emergency care
‘Population health management’ is an approach that will help us to target our collective resources where evidence shows that we can have the greatest impact.
Local government and health organisations, together with the community and voluntary sector, will deliver joined-up services to defined groups of the population. In this way, we will prevent, reduce, or delay need before it escalates; and prevent people with complex needs from reaching crisis points.
Lowneeds
High needs
PHM: Changing the Curve
www.hertfordshire.gov.uk
• Lifecourse approaches
• Connection between NHS Long Term Plan, Prevention Vision, Green Paper and Spending Review
• Impact of Positive Psychology or psychological science in general
• A personalising narrative on health and “lifestyle” not determinants or systems
More Missed Opportunities
www.hertfordshire.gov.uk
www.hertfordshire.gov.uk
Biomedical Psychosocial
SocialStructural and Environmental
“Knowing” an issue in its multiple dimensions
Complexifying Challenges, Solutions
and Knowledge
www.hertfordshire.gov.uk
thank you
Jim.mcmanus@hertfordshire.gov.uk
Public Health: what next?Wednesday 12th June 2019
Professor Wendy Wills
Director, Centre for Research in Public Health and Community Care [CRIPACC]University of Hertfordshire
RESEARCH / PARTNERSHIP WORKING
#hertsphconnect
Public Health: what next?Wednesday 12th June 2019
Dr Zoe Aslanpour
Associate Dean Community, International and Partnership [LMS], University of HertfordshireConsultant in Public Health
MPH – onlineMaster of Public HealthCourse tutor – Dr Marvelle Brown [m.brown24@herts.ac.uk]
DPH – blended learningProfessional Doctorate in Public HealthProgramme Lead – Dr Chaz Simpson [c.m.simpson@Herts.ac.uk]
#hertsphconnect
Public Health: what next?Wednesday 12th June 2019
Ciceley Scarborough
Project Manager, Public HealthHertfordshire County Council
#hertsphconnect
Public Health: what next?
Public Health: what next?
Public Health: what next?
Public Health: what next?
Public Health: what next?
Public Health: what next?Wednesday 12th June 2019
Facilitated roundtable discussions
* What does Public Health mean to you / your organisation?
* What are the most pressing issues facing Public Health?
* How will you be involved in Public Health / Public Health connect?
#hertsphconnect
University of Hertfordshire & Hertfordshire County Council MasterclassPublic Health: what next?
Wednesday 12th June 2019
#hertsphconnect