Public Health challenges in Hertfordshire

Raymond JankowskiDeputy Director of Public Health

Public Health

The art and science of prolonging life, preventing disease and promoting health through the organised efforts of society

3 domains of Public health

• Health improvement• Health protection• Health care

Commissioning Health and Wellbeing for Hertfordshire

Public Health Challenges• Tobacco control• Obesity• Alcohol misuse• Children and young people realising their full potential• Mental health and wellbeing• Supporting older people to live independent lives• Health inequalities• Quality Innovation Productivity Prevention (QiPP)• Climate change• Lifelong learning

Tobacco control: the challenge

• Increase referrals to Hertfordshire smoking cessation services• Reduce number of people starting smoking• Effective communication and social marketing• Reduce supply of cheap and illicit tobacco• Reduce health inequalities

Smoking prevalence in Hertfordshire by age

Girls 9-11 yrs

Boys9-11yrs

Girls15 yrs

Boys15 yrs

Adults Pregnancy

2% 6% 21% 15% 19.5% 10.5%

National target 2015

- -12%

12%

18.5% 11%

Key IMD 3 to 8.9 9 to 14.9 15 to 20.9 21 to 26.9 27 and over

Hertfordshire IMD 2010 by MSOA with district averages

Key Range

  0 to 10.9

  11 to 12.9

  13 to 14.9

  15 to 16.9

  17 to 18.9

  19 and over

GP-recorded Smoking prevalence by MSOA 2010-11

Estimated NHS and wider economy costs of tobacco control in Hertfordshire

• NHS - £54M• Wider economy - £275M

– Cleaning up cigarette butts - £5.8M– Smoke related fires - £8.7M

Summary

Build on a strong Hertfordshire Tobacco Control Alliance, to reduce smoking prevalence by:

• Supporting smokers in priority groups to quit• Continuing to support actions to reduce supply of illicit

tobacco• Reducing the uptake of smoking among young people

Obesity in Hertfordshire: challenges

Prevalence %4-5

year olds10-11

year oldsAdults

8-9% 14-16% 21.4%

Estimated NHS and economic costs in Hertfordshire

NHS Wider economy

2007 £84M £320M

2050 £174M £1000M

Key IMD 3 to 8.9 9 to 14.9 15 to 20.9 21 to 26.9 27 and over

Hertfordshire IMD 2010 by MSOA with district averages

Prevalence of obesity in school age children (Year 6 aged 10-11 years) in MSOAs in Hertfordshire for 2009-10

Key Prevalence of obesity 0 to 8.9% 9% to 13.9% 14% to 18.9% 19% to 23.9% 24% and over

Reducing Obesogenic environment

Individuals,

Families,

Communities

Physical activity

Healthy eating and sensible drinking

Motivation

Self esteem

Cost and availability of leisure facilities

Availability of green space

Cycle lanes

Pedestrian friendly

Community safety

Healthy workplace

Motivation

Self esteem

Cost of healthy eating

Shopping skills

Cooking skills

Availability of fresh produce

Advertising

Healthy workplace

NHS Wider economy

% NHS/wider economy

Tobacco control

£54M £275M 20%

Obesity £84M £320M 26%

Alcohol £54M £400M 13.5%

NHS versus wider economy costs in Hertfordshire

Challenges in older age

• Falls• Dementia• Social isolation• Intermediate care• End of Life• Influenza• Fuel poverty

2007/08 2008/09 2009/10 2010/110

50

100

150

200

250

300

194.29 203.93233.89 248.14

Hospital admissions due to falls in persons aged over 65 in Hertfordshire

Financial year

Dir

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y st

anda

rdis

ed ra

te p

er 1

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Source: NHS Hertfordshire SUS