Health and wellbeing in Brighton and Hove Alistair Hill –Consultant in Public Health
Determinants of health and wellbeing Dahlgren and Whitehead, 1991
Marmot Review 2010:  Reducing inequalities is a matter of fairness and social justice <ul><li>The cost of health inequalit...
Social deprivation in Brighton and Hove ENGLAND SOUTH EAST BRIGHTON & HOVE Most deprived quintile in England Least deprive...
What is the life expectancy gap in Brighton and Hove?
<ul><li>Life expectancy gap is 7.0 years for females and 10.1 for males </li></ul>A journey on the No. 1 Life expectancy g...
“ ... the ability of a community to adapt to pressures and transform itself in ... ways that fundamentally transform the b...
Community resilience in Brighton and Hove The WARM concept of community resilience
WARM assets and vulnerabilities:  Life satisfaction   <ul><li>Satisfaction with living in Brighton and Hove is high, espec...
WARM assets and vulnerabilities:  Education <ul><li>Falling school exclusions. Resilience training (SEAL) embedded in curr...
WARM assets and vulnerabilities: Health <ul><li>Strong correlation between health and affluence.  </li></ul><ul><li>Simila...
WARM assets and vulnerabilities:  Material wellbeing <ul><li>Low exposure to debt.  </li></ul><ul><li>Higher number of inc...
WARM assets and vulnerabilities:  Strong and stable families <ul><li>Lower rate of lone parent and carer claimants  </li><...
WARM assets and vulnerabilities:  Belonging <ul><li>Lower sense of belonging and participation in decision making, overall...
WARM assets and vulnerabilities:  Local economy <ul><li>Small size and short travel times (foot/public transport). </li></...
WARM assets and vulnerabilities:  Public Services <ul><li>By virtue of size most public services are nearby. </li></ul>Hig...
WARM assets and vulnerabilities:  Crime and anti-social behaviour <ul><li>Low fear of crime and average burglary offences....
WARM assets and vulnerabilities:  Infrastructure <ul><li>Peripheral wards have more infrastructure resilience (except Mool...
<ul><ul><li>Demand increasing (population growth) </li></ul></ul><ul><ul><li>Impact of austerity measures </li></ul></ul><...
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City camp health and wellbeing

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CityCamp presentation on health and wellbeing in Brighton and Hove

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  1. 1. Health and wellbeing in Brighton and Hove Alistair Hill –Consultant in Public Health
  2. 2. Determinants of health and wellbeing Dahlgren and Whitehead, 1991
  3. 3. Marmot Review 2010: Reducing inequalities is a matter of fairness and social justice <ul><li>The cost of health inequalities in England </li></ul><ul><ul><li>1.3 - 2.5 million life years every year </li></ul></ul><ul><ul><li>Economic: </li></ul></ul><ul><ul><ul><li>productivity losses of £31-33B </li></ul></ul></ul><ul><ul><ul><li>reduced tax revenue and welfare payments of £20-32B </li></ul></ul></ul><ul><ul><ul><li>increased treatment costs > £5B. </li></ul></ul></ul><ul><li>Beyond economic growth – to wellbeing </li></ul><ul><li>Action required </li></ul><ul><ul><li>Across all social determinants </li></ul></ul><ul><ul><li>From preconception to the grave – the lifecourse </li></ul></ul>
  4. 4. Social deprivation in Brighton and Hove ENGLAND SOUTH EAST BRIGHTON & HOVE Most deprived quintile in England Least deprived quintile in England MID SUSSEX
  5. 5. What is the life expectancy gap in Brighton and Hove?
  6. 6. <ul><li>Life expectancy gap is 7.0 years for females and 10.1 for males </li></ul>A journey on the No. 1 Life expectancy gap between the most affluent and most deprived is 7 years in women and 10 years in men Life expectancy 78.6 years Life expectancy 75.4 years Life expectancy 77.4 years Life expectancy 80.9 years
  7. 7. “ ... the ability of a community to adapt to pressures and transform itself in ... ways that fundamentally transform the basis of the community.” Australian Social Inclusion Board, June 2009
  8. 8. Community resilience in Brighton and Hove The WARM concept of community resilience
  9. 9. WARM assets and vulnerabilities: Life satisfaction <ul><li>Satisfaction with living in Brighton and Hove is high, especially for older people. </li></ul><ul><li>Many LGBT community members move to the city because it is LGBT-friendly </li></ul><ul><li>Limited BME perspective in this model. </li></ul><ul><li>Strong correlation between satisfaction and affluence, although even in some deprived wards satisfaction is high </li></ul><ul><li>Satisfaction is not translated into a sense of belonging. </li></ul>( Proxy of “satisfaction with living here” used )
  10. 10. WARM assets and vulnerabilities: Education <ul><li>Falling school exclusions. Resilience training (SEAL) embedded in curriculum but not evaluated, good primary school performance. </li></ul><ul><li>Underperformance in GCSE results </li></ul><ul><li>Highly educated working age adults and older people. </li></ul><ul><li>Imported educated workforce placing pressure on longer term residents. </li></ul><ul><li>Highly educated LGBT with high levels of peer support in Education Institutions. </li></ul><ul><li>Bullying of certain groups may reduce attendance. </li></ul><ul><li>Scope to improve resilience through vertical integration </li></ul>
  11. 11. WARM assets and vulnerabilities: Health <ul><li>Strong correlation between health and affluence. </li></ul><ul><li>Similar pattern of health assets and vulnerabilities across young people, adults and older people. </li></ul><ul><li>Population is generally more fit, relatively good diet, lower levels of obesity. </li></ul><ul><li>Relatively high rates of alcohol and substance use. </li></ul><ul><li>High rates of sexual health and mental health issues. </li></ul><ul><li>Opportunities for cross-generation / vertical integration initiatives. </li></ul>
  12. 12. WARM assets and vulnerabilities: Material wellbeing <ul><li>Low exposure to debt. </li></ul><ul><li>Higher number of income support </li></ul><ul><li>and incapacity benefit claimants </li></ul><ul><li>Single parent families, older people and carers struggle. </li></ul><ul><li>Need to maximise benefit uptake – in context of welfare reforms </li></ul>
  13. 13. WARM assets and vulnerabilities: Strong and stable families <ul><li>Lower rate of lone parent and carer claimants </li></ul><ul><li>Many elderly live alone and are potentially socially isolated. </li></ul><ul><li>High levels of mental health problems, substance misuse and domestic violence – including among LGBT communities. </li></ul>
  14. 14. WARM assets and vulnerabilities: Belonging <ul><li>Lower sense of belonging and participation in decision making, overall average levels of volunteering. </li></ul><ul><li>Higher participation of children in group activities. </li></ul><ul><li>Older people most involved in decision making. </li></ul><ul><li>LGBT volunteering high however lower feelings of local area inclusiveness. </li></ul>
  15. 15. WARM assets and vulnerabilities: Local economy <ul><li>Small size and short travel times (foot/public transport). </li></ul><ul><li>Creative businesses, business start ups and business density. </li></ul><ul><li>Geographical differences. </li></ul>
  16. 16. WARM assets and vulnerabilities: Public Services <ul><li>By virtue of size most public services are nearby. </li></ul>Higher levels of public satisfaction with public transport services. Vulnerable residents and older people more likely to feel that services respond to their need. However relatively low level of public satisfaction with public services with regard to City Council, GP, local hospital and dental services.
  17. 17. WARM assets and vulnerabilities: Crime and anti-social behaviour <ul><li>Low fear of crime and average burglary offences. </li></ul><ul><li>Initiatives tackling antisocial behaviour rates (including alcohol). </li></ul>However overall crime, anti-social behaviour, violent crime are relatively high. Crime matches deprivation profile. Crime falling less than it is elsewhere in Sussex. Evidence of hate crime against LGBT community.
  18. 18. WARM assets and vulnerabilities: Infrastructure <ul><li>Peripheral wards have more infrastructure resilience (except Moolescomb and Bevendean) </li></ul>Housing is a powerful vulnerability. High levels of satisfaction with parks, green spaces and seafront.
  19. 19. <ul><ul><li>Demand increasing (population growth) </li></ul></ul><ul><ul><li>Impact of austerity measures </li></ul></ul><ul><ul><li>The end of increases in public sector spending </li></ul></ul><ul><ul><ul><li>“ the Government has run out of money” George Osborne 26/2/12 </li></ul></ul></ul><ul><ul><ul><li>“ Austerity is the new normal” Alan Milburn </li></ul></ul></ul><ul><ul><li>Contribution of carers and community &voluntary sector </li></ul></ul><ul><ul><li>Outcomes that are important to users and communities </li></ul></ul><ul><ul><li>Services must recognise impact of assets and resilience </li></ul></ul><ul><ul><li>More integration between services </li></ul></ul><ul><ul><li>New health commissioning structures (tbc) </li></ul></ul>Future challenges...and opportunities for health and wellbeing
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