promoting health and wellbeing - vision, practice and reality | dr neil hamlet
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Promoting Health & Wellbeing – vision, practice and reality
Neil HamletConsultant Public Health Medicine
What does ‘the good life’ look like?What’s it made of?
What are health inequalities?Health inequalities are:• Unfair differences in health within the
population across social classes and between different population groups (ethnicity, income, gender, education, geography)
These differences are unfair because they:• Are not random, or by chance, but largely
socially determined • Not inevitable
• …..…a lot like cancer
In-equality Drivers ‘unprotected characteristics’
• sex• religion or belief• age• sexual orientation • disability • race • pregnancy and
maternity• gender reassignment• marriage and civil
partnership
• Inequitable distribution of :• Power• Money• Resources
• Early life experience• Education• Work opportunity• Support networks• Home environment• Local environment• Personal behaviours
Equality Strands‘protected characteristics’
Impact of Deprivation on Health
Source:
Male Female Most deprived
Male Female Least deprived
0
10
20
30
40
50
60
70
80
2325.7
12.5 12.2
49.652.7
70.473
Years in 'not' good health
Life Expectancy
Scottish Household Survey/National Records Scotland
Health
is…...the emergent property of a
well functioning society
for all
The determinants of health
What drives the inner motivators of our personal cancer promoting behaviours?
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Most Deprived Q2 Q3 Q4 Leaset Deprived
Decreasing Deprivation
% o
f adu
lts
Fife
Smoking prevalence – intermediate driver of health inequality
Source: Fife Scottish Health Survey Results 2008-11
Proportionate
Universalism
Salutogenic Engineering
“Every healthcare contact is a health improvement opportunity”
‘2020 Vision’, Scottish Government, 2012
“Making HPHS part of NHS Scotland's DNA”
“We will have a healthcare system where we have:Integrated health and social care, A focus on:•Prevention•Anticipation•Supported self-management”
HPHS CEL - InterventionsCore actions
Smoking
Alcohol
Food and health
Physical Activity
Maternity
Reproductive health
Staff health & wellbeing
Active Travel
Knowledge Network: HPHS portal
The one-stop-shop for information on health
improvement in the
hospital setting
http://www.knowledge.scot.nhs.uk/home/portals-and-topics/health-improvement/hphs.aspx
Virtual Learning Environment
HPHS contact: [email protected] Knowledge Network Portal:www.knowledge.scot.nhs.uk/home/portals-and-topics/health-improvement/hphs.aspx
“Every health care contact is a health improvement
opportunity”
The life cycle of a cancer
time
Death
Symptoms
Detectable
Onset
Screening test applicable
Detectable preclinical phase- lead time
The Teachable Moment
Warm the water
Keep chipping
away