The document discusses health inequalities and social determinants of health. It defines health inequalities as unfair differences in health between social groups that are largely socially determined and not by chance. It lists factors like income, education, gender, ethnicity, and geography that impact health. The document advocates for a focus on prevention, anticipation, and supported self-management in healthcare to address inequalities and promote health and wellbeing for all. It discusses using opportunities in healthcare to improve health and engaging in proportionate universalism.

1. Promoting Health &
Wellbeing – vision, practice
and reality
Neil Hamlet
Consultant Public Health Medicine
neil.hamlet@nhs.net

2. What does ‘the good life’ look like?
What’s it made of?

3. 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

4. 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’

5. Impact of Deprivation on Health
Source:
23
25.7
12.5 12.2
49.6
52.7
70.4
73
0
10
20
30
40
50
60
70
80
Male Female Most deprived Male Female Least deprived
Years in 'not' good health
Life Expectancy
Scottish Household Survey/National Records Scotland

6. Health
is….
..the emergent property of a
well functioning society
for all

7. The determinants of health
What drives the inner motivators of our
personal cancer promoting behaviours?

8. 0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Most Deprived Q2 Q3 Q4 Leaset Deprived
Decreasing Deprivation
%ofadults
Fife
Smoking prevalence – intermediate
driver of health inequality
Source: Fife Scottish Health Survey Results 2008-11

9. Proportionate
Universalism
Salutogenic
Engineering

10. “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”

11. HPHS CEL - Interventions
Core actions
Smoking
Alcohol
Food and health
Physical Activity
Maternity
Reproductive health
Staff health & wellbeing
Active Travel

12. 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

13. Virtual Learning Environment

14. HPHS contact:
nhs.HealthScotland-hphsadmin@nhs.net
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”

15. The life cycle of a cancer
time
DeathSymptomsDetectableOnset
Screening test applicable
Detectable
preclinical phase- lead time
The Teachable
Moment

16. Warm the water
Keep
chipping
away