fit for the future leading the way in health & care prevention & early intervention:...
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FIT FOR THE FUTURELeading the way in health & care
PREVENTION & EARLY INTERVENTION: EVIDENCE & PRACTICEChair: Dave Dawes, Nurse First CIC
Jessica Allen, UCL Institute of Health EqualityLyn Bacon, Nottingham CityCare Partnership
Ivo Gormley, GoodGym
#fitforthefuture@SocialEnt_UK
Dr Jessica AllenDeputy Director,UCL Institute of Health Equity
Intervening Early for health equity
Inequalities in health
• Related to socio-economic status (conditions of daily life)
• Result in persistent health inequalities
Intervening early before ill health sets early and intervening early in life
–Saves lives–Effective –Cost effective
Inequalities and poor health are expensive
Costs of doing nothing on health inequalities
• England approx £70 billion annually
• EU approx 1.3 trillion euros
A. Give every child the best start in life
B. Enable all children, young people and adults to maximise their capabilities and have control over their lives
C. Create fair employment and good work for all
D. Ensure healthy standard of living for all
E. Create and develop healthy and sustainable places and communities
F. Strengthen the role and impact of ill health prevention
Fair Society: Healthy Lives: 6 Policy Objectives
Intervening early in life
• Most effective• Disrupt the accumulation of disadvantage which
leads to shorter life
Per cent 5 year olds achieving ‘good development score’,* Birmingham LA, West Midlands & England
*in personal, social and emotional development and communication, language and literacy
Source: Department for Education
%
Self reported health by education and social expenditures: 18 EU countries
0
0.05
0.1
0.15
0.2
0.25
Net Total Social Expenditures in PPP's
Primary
Predicted probability
of poor health
Minimum Maximum0
0.05
0.1
0.15
0.2
0.25
Primary
Secondary
Tertiary
Predicted probability
of poor health
Net Total Social Expenditures in PPP's
Source: Dahl & van der Wel, data from EU SILC 2005
Action on inequalities depends on:
Political Leadership
Sector Leadership
– Evidence– Financial case– Delivery and implementation– Levers and accountabilities– Advocacy and persistence
LOCAL IMPACT: DH remit
• Local authorities –75% of local authorities have been
significantly influenced by Marmot, evidence by their Health and Well-being Strategies and JSNAs (joint Strategic Needs Assessments)
–We have worked directly with 40 plus local authorities
Health Inequalities legislation
• Legal duties to reduce health inequalities for the first time
• Platform for joining up health services, social care services and health-related services at local level
National government’s response to Marmot review
Public Health White Paper accepted:
• the need to address the social determinants of health
• The life course approach
• the importance of the social gradient
• and approved the use of proportionate universalism
Social Value ActAct 2012 public bodies in England and Wales must consider: • How what is being proposed to be procured might
improve the economic, social and environmental well-being of the relevant area, and
• How, in conducting the process of procurement, it might act with a view to securing that improvement”
FIT FOR THE FUTURELeading the way in health & care
PREVENTION & EARLY INTERVENTION: EVIDENCE & PRACTICEChair: Dave Dawes, Nurse First CIC
Jessica Allen, UCL Institute of Health EqualityLyn Bacon, Nottingham CityCare Partnership
Ivo Gormley, GoodGym
#fitforthefuture@SocialEnt_UK
http://www.nottinghamcitycare.nhs.uk/small-steps-big-changes-funding-win/