(public health) presentation for the South west regional public health training conference, October 13th 2016.

1. South West Regional Public Health
Training Conference
October 13th 2016
THE BEST JOB IN THE WORLD
John Middleton
President for policy
UK Faculty of Public Health

2. JMiddleton October 13th 2016
Public
‘ealth

4. Salus populi suprema
lex esto
Cicero
‘The health of the
people is the highest
law’

18. Sandwell Valley,
King George
Playing fields
2014

22. New leisure
centres Tipton

24. Working with long time constants

25. Improving
outcomes

26. A life course – 24th annual report for
Sandwell

27. CHD Mortality 2000-2005
PERSONS, Less than 65 years
0.00
10.00
20.00
30.00
40.00
50.00
60.00
2000 2001 2002 2003 2004 2005
Rateper100,000
West Midlands England Sandwell

28. 28

29. 29

31. Long term conditions

32. Figure 1, Teenage Conception 1998 - 2012
Sandwell's reduction since baseline (44%) is higher than England &
Wales's reduction of 40.8%. The West Mildands reduction has also
been lower than Sandwell at 42%. Figure 1, above, show that the
gap between Sandwell and England is reducing further.

33. • Maximise the capabilities
and control young and
adults
people have over their lives
: reduce the social gradient
of skills and qualifications

34. Working together, March 2015: John Middleton Vice president Faculty of Public Health

35. Working together, March 2015: John Middleton Vice president Faculty of Public Health

36. Marsch Addiction 1997

37. Domestic burglary Sandwell 2001-2005Full implementation
drug intervention
project doubling
numbers of drug users
in treatment
1300 fewer
domestic
burglaries
33% fall

40. South West Public Health Training Conference Conference, JMiddleton October 13th 2016
• I recommend Sandwell reviews its clinical policies for management
of failure of growth in the womb.
•
• I recommend this review be undertaken for the conurbation as well
if this can be agreed and organised rapidly.
•
• I recommend that the review should involve externally
commissioned experts with a national or international reputation.
•
• We need a new strategy for improving outcomes for pregnant
mothers, newborn babies and their families.
•

41. Housing and health

42. South West Public Health Training Conference Conference, JMiddleton October 13th 2016
Housing
• Housing and health work in community regeneration
• Self build housing project in Health action zone
• Housing and health strategies since 1999
Based on:
Numbers of houses
Quality of houses
Quality of neighbourhood
Relationship to planning
Relationship to planning out crime

43. South West Public Health Training Conference Conference, JMiddleton October 13th 2016
A box plot of the
Baseline SAP
measures for the
Sandwell MBC
housing stock,
1st April 2001, by
housing type,
n=25,595 dwellings

44. South West Public Health Training Conference Conference, JMiddleton October 13th 2016
A box plot of the
Baseline SAP
measures for the
Sandwell MBC
housing stock,
31st March 2011,
by housing type,
n=25,595
dwellings

45. Housing and health -Results:
Significant relationship of improved thermal
efficiency with reducing excess winter deaths
Adjusting for all of the other variables there is
negative association between improved thermal
efficiency and the odds of being admitted as an
emergency
People in warmer homes appear to be admitted less
for serious illnesses
The result is statistically significant
The effect size appears large

46. The three domains of public health
South West Public Health Training Conference Conference, JMiddleton October 13th 2016
Health protection
Health improvement
Health care public health

47. The three domains of public health
South West Public Health Training Conference Conference, JMiddleton October 13th 2016
Health protection
Health improvement
Health care public health

48. Local authorities must grasp their health
protection responsibilities- and opportunities
Major role in prevention of infection-
• All of the work of environmental health officers
• High risk workplace situations for TB prevention
• Hepatitis C education eg. in Pakistani community
• Blood borne viruses in drug users
• Oversight of immunisation outcomes and local school and other
support
• Reducing costs of social care by care home support infection
control
South West Public Health Training Conference Conference, JMiddleton October 13th 2016

49. The three domains of public health
South West Public Health Training Conference Conference, JMiddleton October 13th 2016
Health protection
Health improvement
Health care public health

50. Local authorities must grasp their responsibilities and
opportunities in health care related public health
• Respond to NHS five year plan for prevention
• Respond to National Audit Office concern about the
failure to honour the ‘Core public health offer’
• Rise to the challenge of the Manchester initiative, and
be the intelligent, strategic leaders of whole system
health, social and preventive health – ‘needs-led and
evidence-based’
South West Public Health Training Conference Conference, JMiddleton October 13th 2016

51. Table 2 a Preventable causes of hospital admission, Sandwell and Western
Birmingham Clinical commissioning group, 2012-13

53. South West public Health Training Conference Conference, JMiddleton October 13th 2016

54. The three domains of public health
South West public Health Training Conference Conference, JMiddleton October 13th 2016
Health protection
Health improvement
Health care public health

58. Options for life self-built community centre

59. Options for life

60. Good corporate citizen award
38 apprentices
Rationalisation of offices : 6
leases surrendered
890 tonnes of CO2 reduction
£200k saved

63. Healthy towns-West Midlands town
planning and public health group
• Healthy urban development
approach
• Working with town planners and
transport engineers – to influence
policy and design
• Emphasis on environment and
open spaces- create safer places
where people
• Encouraged to walking and cycling
• Health impact assessment on all
developments
• Spin off for comments on health
care impacts eg new nursing
homes
• Interest in food access and the
food economy for health

65. The food desert becomes the
fat swamp

68. Where there is no vision the
people suffer
Andrija Stampar, Yugoslavian Public health pioneer and WHO founding
father
After Proverbs/29-18.
South West public Health Training Conference Conference, JMiddleton October 13th 2016

69. South West public Health Training Conference Conference, JMiddleton October 13th 2016

70. South West public Health Training Conference Conference, JMiddleton October 13th 2016
1001 critical days
Personal health and social
relationships education, PHSE in all
schools
2 hours physical activity per week
reinstated

71. South West Public Health Training Conference Conference, JMiddleton October 13th 2016
Stop marketing of foods high in sugar, salt and fat,
before the 9pm watershed and tighten marketing
restrictions
Introduce 20% duty on sugar sweetened beverages
Tackle alcohol related harm by introducing a minimum
unit price for alcohol of at least 50p
Rapidly implement standardised tobacco packaging
20 Mph speed limits

72. South West Public Health Training Conference Conference, JMiddleton October 13th 2016
A living wage
Reaffirm commitment to universal
health care system free at the point of
need funded through general taxation

73. South West public Health Training Conference Conference, JMiddleton October 13th 2016

74. South West public Health Training Conference Conference, JMiddleton October 13th 2016
Invest in active transport to promote good
health and reduce our impact on climate change
Implement a cross national approach to meet
climate change targets, including a rapid move to
a 100% renewables and a zero carbon energy
system

75. My presidency
Build local authority relationships
Build relationships in health and public health
services in four nations of the UK
Do things jointly where possible - policy statements,
conferences
Implement new curriculum: personal effectiveness
and values and ethics; rebuild health protection and
health care public health
Develop member involvement
Ensure solid member services, build special interests
Develop faculty governance
Pursue 12 asks of the Manifesto
Planetary health
A Public health curriculum for young people
Brexit, drugs, air pollution, AMR, violence prevention
‘Don’t just fight for the profession of public health
but for the public’s health’

76. South West public Health Training Conference Conference, JMiddleton October 13th 2016
Wolverhampton
University’s Health
Futures University
Technical college , being built
in West Bromwich, opening
Autumn 2015
Providing education
and prospects for
careers in health,
public health and
care for 14-19 year
olds

77. And to conclude ……

80. it's not who
your doctor
is, it's who
you vote for,
that most
affects your
health

81. Thank you
Professor John Middleton
Faculty of Public Health
president@fph.org.uk