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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


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


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


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


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


DPH Report 2018-19


• 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


Mental Health JSNA, 2015


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


• 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


Govt says the Green Paper will…

We need to push heavily on this. It’s the weakest section of the Green Paper


DHSC Slides


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?


DHSC Slides


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


• Population Health

– Wider Determinants

– Sustainability

• Population Health Management

• No Health Without Mental Health

• Complexifying

• Systems Approaches

• Better use of Data and Informatics

Opportunities


A Public Health

Wales take


Determinants


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


• 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


Biomedical Psychosocial

SocialStructural and Environmental

“Knowing” an issue in its multiple dimensions

Complexifying Challenges, Solutions

and Knowledge


thank you

[email protected]

mailto:[email protected]


Professor Wendy Wills

Director, Centre for Research in Public Health and Community Care [CRIPACC]University of Hertfordshire

RESEARCH / PARTNERSHIP WORKING

#hertsphconnect


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 [[email protected]]

DPH – blended learningProfessional Doctorate in Public HealthProgramme Lead – Dr Chaz Simpson [[email protected]]

#hertsphconnect


Ciceley Scarborough

Project Manager, Public HealthHertfordshire County Council

#hertsphconnect

Public Health: what next?


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

University of Hertfordshire & Hertfordshire County Council ... · mental disorder (equating to...

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