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Notes from Thursday 29 April, Middlesbrough Football Club
The day kicked off with Sally Young, North East Regional Manager, thanking everyone for their continuing commitment to improving health and stating that the day would focus on the Choosing Health Consultation. She announced the results of a survey of forum members that asked them to identify their top priorities for improving health in the North East. The top three were:
• Smoking cessation
• Communication
• Waiting Times
Leslie Forsythe, Director of Operations for the North, was up next and gave an update on the development of the Shaping Health Network. He reminded attendees that the Commission was one year old, however the PPI Forum members have only been in place for 16-18 weeks. Leslie noted that the newness of the organisation has meant a bumpy relationship development process in the beginning. However, since January 1005 forum meetings have been held, and most forums have held their first public meeting.
The Commission is working toward a broad range of representation. At the moment, 1/3 of forum members have disabilities, 10% are ethnic minorities and there is a 50/50 split between male and female forum members.
Leslie continued that CPPIH is a brand new national non-profit organisation, created in a very short time, with a purpose to improve health by engaging citizens at the heart of health decision making. He saw partnership as key to achieving this and stated Forums We should get involved with established networks.
Scrutiny was also viewed as central, including visits, getting feedback and focusing on significant areas of work.
The Shaping Health Network’s work is not just about the NHS. It is also about preventative measures, solving problems on a permanent basis and not just fighting fires locally. It’s about understanding the prevention and health agenda.
Leslie concluded by saying that there is a real sense of possibility and exciting opportunities for changing health.
David Walker, Director of Public Health for County Durham and Tees Valley, then gave a presentation about health in the North East. (See below)
In the afternoon, forum members looked at parts of the Choosing Health consultation, and gave feedback.
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Improving Health In the North East by David Walker
At the Regional Launch on 29th April David Walker gave the following presentation
NORTH EAST HEALTH
How healthy are we?
What are the causes of our ill health?
What challenges do we face?
Where are we now?
The North East has:
-the worst health in the country...
Death rates 10% above England, 20% above East of England
…the highest chronic illness rate...
27% above England, 47% above South East
…the highest levels of poor health...
33% above England, 68% above South West
…the highest circulatory disease rates...
13% above England, 25% above South East
…the highest cancer death rates...
16% above England, 24% above South West
…the highest teenage conception rates...
20% above England, 48% above South East
The North East has:
the highest death rates
the highest levels of illness
the highest reported sickness levels
the most CHD and cancer (and others)
the highest teenage pregnancy rates
***A pattern of health more comparable with
eastern European countries than Southern England***
We have the highest rates of acute activity in the country...
Emergencies 27% above England, 50% above London
… and the highest rate of electives...
27% above England, 49% above South East
How good are health services in the North East ?
Very good.
*All trusts have 2 or 3 stars
*Meeting waiting times better than national average
*Activity per head and per unit cost greater than national average
*Many nationally recognised examples of good practice
CHI news January 2003
“Hospitals in the north of England have better arrangements for providing care to patients than those in London and the South.”
The North East has the worst deprivation in the country...
GDP 25% below England, 40% below London
…the lowest household expenditure...
15% below England, 32% below London
…second highest unemployment rate...
21% above England, 62% above South East
…the highest level of deprived wards...
Twice the level expected, five times the South East level
The North East has:
the greatest economic deprivation
the lowest household expenditure
almost the highest unemployment
the largest proportion of deprived wards
These are known to be the most significant determinants of the health of a population
PUBLIC HEALTH CHALLENGES
Address underlying health determinants:
*education and employment
*economic wellbeing
*social cohesion
*Tackle major risk factors
Smoking
*Obesity, diet and exercise
*Continue improving health services
Addressing these challenges is the most far-reaching public health measure
Being healthy
*Don’t smoke
*Don’t be obese
*Take more exercise
*Eat wholegrain foods, fruit, fish
*Be educated
*Be personally richer
*Be in a stable and loving relationship
*Be more autonomous
*Drink alcohol in moderation, but much more water
*Avoid toxins (passive smoke, traffic emissions, asbestos, lead)
*Take folate, statins(?)
*Get treatment when you need it
*Be screened and immunised
*Exercise
Walking 2 miles a day when compared with < 1 mile per day reduces mortality over 12 years by 20%
Exercise & diet programmes in overweight people with IGT reduces progression to diabetes by up to 70%
Supervised exercise for heart failure halves mortality and hospital admissions and substantially increases quality of life
Value for money
"Exercise in the prevention of coronary heart disease – today's best buy in public health"
Morris, 1994
Why don’t families exercise?
Fear of molestation or injury on the roads
Children no longer play in roads
Insufficient gardens in urban areas
Public play areas feared
Two working parents
2nd car essentially for school run
More cars lead to social isolation
Food shopping at major supermarkets
Food deserts arise
Socially isolated lose access to better food
SPECIFIC MEASURES
Physical activity
CHD and Stroke
Diabetes
Joint diseases
Cancers (probably)
Smoking cessation
Cancers (many)
CHD and Stroke
Respiratory diseases
Improved diet
CHD and Stroke
Cancers (many)
Diabetes
Joint diseases
PROGRESS AND CHALLENGES
In the North East, we have:
the most challenging health problems
the most difficult underlying problems
We have begun to make progress
But much remains to be done
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