Dr John Middleton, SHOES Conference, March 28 2014, part 4

Dials & levers:SHOES ,March 2014: John Middleton DPH Sandwell

A life course

3 successes

A life course – 24th annual report for Sandwell

Long term conditions

Figure 1, Teenage Conception 1998 - 2012    

Sandwell's reduction since baseline (44%) is higher than England & Wales's reduction of 40.8%. The West Mildands reduction has also been lower than Sandwell at 42%. Figure 1, above, show that the gap between Sandwell and England is reducing further.

Getting research into practice? John Middleton Lancet Public Health Research Conference 29th November 2013

Housing and health

Getting research into practice? John Middleton Lancet Public Health Research Conference 29th November 2013

A box plot of the Baseline SAP measures for the Sandwell MBC housing stock, 1st April 2001, by housing type, n=25,595 dwellings

Getting research into practice? John Middleton Lancet Public Health Research Conference 29th November 2013

A box plot of the Baseline SAP measures for the Sandwell MBC housing stock, 31st March 2011, by housing type, n=25,595 dwellings

Housing and health -Results:

Significant relationship of improved thermal efficiency with reducing excess winter deaths Adjusting for all of the other variables there is negative association between improved thermal efficiency and the odds of being admitted

as an emergency People in warmer homes appear to be admitted less for serious illnesses

The result is statistically significant The effect size appears large

• I recommend Sandwell reviews its clinical policies for management of failure of growth in the womb.

• • I recommend this review be undertaken for the conurbation as well

if this can be agreed and organised rapidly.• • I recommend that the review should involve externally

commissioned experts with a national or international reputation. • • We need a new strategy for improving outcomes for pregnant

mothers, newborn babies and their families. •

Challenges Children ready for school Young people ready for workUrgent care/whole health system capacity management Private sector housing fit to live in And a whole community facing up to climate collapseAnd an economy gearing for a green revolution

An Asset based approach

To health improvement and community resilience Self reliant communities ward profiles Spend to save- one off opportunity presented by public health budget for projects to reduce spend in future More help, less care

Four dividends for a healthier future

The health dividend

Four dividends for a healthier future

The inclusion dividend

Birmingham Sandwell / Urban Living Smart housing manifesto 2004

The Future?

Easy to use Patient Graphic interface

Wireless or wired devices, POTS and IP Communications

Software based product – operates on a variety of devices in expanding applications

Standard protocols – easy customization

Tablet PC CareCompanion II Handheld devices

Four dividends for a healthier future

The green dividend

The green recovery ?

Four dividends for a healthier future

The peace dividend

John Middleton Vice President Faculty of Public Health

vppolicy@fph.org.uk