View
215
Download
1
Category
Tags:
Preview:
Citation preview
"Practical Public Health for the Geriatrician".
Paul JohnstonePHERegional Director North of England
1
What is Public Health?
Facts and figures
Older people focus
How is PH organised?
How to get involved and work on Dementia
2
What is public health?The Faculty defines public health as:
The science and art of promoting and protecting health and well-being, preventing ill-health and prolonging life through the organised efforts of society.
3
Public health:is population based not patient individual base
emphasises collective responsibility for health, its protection and disease prevention
recognises the key role of the state, linked to a concern for the underlying socio-economic and wider determinants of health, as well as disease
emphasises partnerships with all those who contribute to the health of the population.
4
Determinants of Health
5
Three domains of public health practice:Health Improvement
Inequalities, Education, Housing, EmploymentFamily/communityLifestylesSurveillance and monitoring of specific diseases and risk factors
Improving servicesClinical effectiveness, EfficiencyService planningAudit and evaluation, Clinical governanceEquity
Health ProtectionInfectious diseasesChemicals and poisons, RadiationEmergency responseEnvironmental health hazards
6
Public health and healthcare success stories
7 A tale of two populations- 26th Sept 2013
Data Source: Mortality in England and Wales Average Life Span, December 2012
8 Presentation title - edit in Header and Footer
Data Source HSE 2011 Volume 1 HSCI
9 Presentation title - edit in Header and Footer
Greatest reduction in
CVD
Data source Avoidable Mortality in England and wales 2011 ONS may2013
Public health working with healthcare professionals- reducing stillbirths.
10
Unfinished business- inequalities
11 Presentation title - edit in Header and Footer
Source: ONS Statistical bulletin Life expectancy at birth and at age 65 for local areas in England and Wales, 2009-11
Data source: ONS Inequalities in LE and DFLE , 2001-2004 to 2007-2010
12
Increasing retirement age will not increase tax revenue if people are too ill to work
By the time retirement age
reaches 68, only the richest 10% of people
will reach retirement
without disability
Years of disability and dependency
Source: ONS 2007
Figure 4: Variation in estimated years of male disability and poor health at birth in Yorkshire and the Humber (based on 2001 Census data)
0 10 20 30 40 50 60 70 80 90
Barnsley
Harrogate
Ryedale
Life expectancy Healthy life expectancy Diability free life expectancy
Age in years
Source: ONS 2007
Figure 5: Variation in estimated years of female disability and poor health at birth in Yorkshire and the Humber (based on 2001 Census data)
0 10 20 30 40 50 60 70 80 90
Barnsley
Harrogate
Ryedale
Life expectancy Healthy life expectancy Disability free life expectancy
Age in years
Obese
930,000Obese
930,000
Morbidly obese
83,000
Healthy weight
1.65 m Over-weight
1.45 m
2009 2015Morbidly obese
96,000
Obese
1.45 mOver-weight
1.48 m
Healthy weight
870,000
Unfinished business- obesity
Unfinished business- primary care
Unfinished Business- primary care prevention
Immediate causes of disease burden
16 Strategic Review
Ed AM, Monika
17
Top causes of under 75 mortality – 2010 Top causes of under 75 mortality – 2010
Raised blood pressure accounts
for 50% of all heart disease
Raised blood pressure accounts
for 50% of all heart disease
Around 86% of lung cancer
deaths in the UK are caused by
tobacco smoking
Around 86% of lung cancer
deaths in the UK are caused by
tobacco smoking
…leading to the major killers.
Causes of long term disability
18
http://www.wmpho.org.uk/olderpeopleatlas/Atlas/atlas.html
19
What is Public Health?
Facts and figures
Older people focus
How is PH organised?
How to get involved and work on Dementia
20
Public Health England
21 Presentation title - edit in Header and Footer
“Public Health England exists to serve the system, a
system led locally by elected members”
22
PHE’s National PrioritiesREDUCING PREVENTABLE DEATHS
Helping people to live longer by reducing preventable deaths fromconditions such as heart disease, stroke, cancer and liver disease
REDUCING THE BURDEN OF DISEASE Increasing healthy life expectancy by tackling conditions which place a
burden on many lives, such as anxiety, depression and back pain
PROTECTING THE COUNTRY’S HEALTHProtecting the population from infectious diseases and environmental hazards,including emerging risks and the growing problem of antimicrobial resistance
GIVING CHILDREN AND YOUNG PEOPLE THE BEST POSSIBLE STARTSupporting families to give children the best start in life, through working with
health visitors, Family Nurse Partnerships and the Troubled Families Programme
IMPROVING HEALTH IN THE WORKPLACEHelping employers to facilitate and encourage their staff to make healthy choices
PHE’s local presence
23
– Four regions, fifteen centres
– Centres in North:
–Cumbria and Lancs
–Cheshire and Mersey
–Greater Manchester
–Yorkshire and Humber
–North East
– Knowledge Intelligence Teams–North West–Northern and Yorkshire
– Other local presence–microbiology laboratories–field epidemiology teams–Centre for Radiation, Chemicals and Environmental Hazards units
Place-based approach to public health
24
Public health advice
Health and wellbeing boardsHealth and wellbeing boards
Local governmentLocal government CCGsCCGsPHEcentre
NHSE area team
• EPPR• Screening and immunisation• Offender public health programmes• Specialised commissioning• Primary care public health programmes
and population healthcare
NHS providers
Non-statutory
providers*People and communities
*Including voluntary and community sector
What is Public Health?
Facts and figures
Older people focus
How is PH organised?
How to get involved?
25
http://www.makingeverycontactcount.co.uk/
Cross-government narrative on health26
Political
27 Strategic Review
28 Presentation title - edit in Header and Footer
LondonNorth East
North West
Yorkshire and the Humber
West Midlands
East Midlands
East of England
South West
South East
Spending power cut per dwelling 2010/11 to 2015/16
Source: Association for North East Councils: Response to DCLG’s consultation on the provisional local government finance settlement 2014/15 Annex A
-544 -467 -417 -357 -339 -238 -146 -146 -105
-£600
-£500
-£400
-£300
-£200
-£100
£0
England
Local Govt Funding and Social Care
Dementia
National Executive Meeting 18 February 2014
Why is dementia an area of focus?
Health Impact • Dementia is the 3rd leading cause of disability for the over 70s, and the 10 th leading cause of premature mortality for all ages (GBD – UK figures)
• c.25% of hospital beds are occupied by people with dementia, with increased length of stay• c.21m people in England know a close friend or family member with dementia
Health Inequalities
• Higher vascular risk in certain BAME communities and socioeconomic groups• Particularly challenging cultural norms in many BAME communities• Women more likely to develop dementia and to be carers
Unique System Leadership
• All major dementias have a vascular component (eg 80% in Alzheimer’s)• Opportunity to build on successful primary prevention approaches for eg heart disease and
stroke• PHE expertise in social marketing and national corporate partnerships
Effective Interventions
• The evidence on prevention is growing - particular benefits in midlife• Opportunity to build on existing Dementia Friends and Dementia Friendly Communities
programmes with new social marketing approaches
Responsiveness
• Numbers of people with dementia are expected to rise as population ages – need to get ahead of the curve as well as improving support for people now.
• DPHs require data, intelligence, and best practice interventions
31
Dementia Friends Movement in Partnership with Alzheimer's Society in
2014/15
:
Recommended