public health in yorkshire and the humber

Public Health in Yorkshire and the Humber

Stephen Morton, Centre Director, Yorkshire and the Humber

Our missionOur mission is to protect and improve the nation’s health and to address inequalities, working with national and local government, the NHS, industry, academia, the public and the voluntary and community sector.

What we want to be known forWe want to be known for encouraging evidence-led action with scale and pace to make a significant and sustainable improvement to the public’s health

Our Priorities

1. Helping people to live longer and more healthy lives by reducing preventable deaths and the burden of ill health associated with smoking, high blood pressure, obesity, poor diet, poor mental health, insufficient exercise, and alcohol

2. Reducing the burden of disease and disability in life by focusing on preventing and recovering from the conditions with the greatest impact, including dementia, anxiety, depression and drug dependency

3. Protecting the country from infectious diseases and environmental hazards, including the growing problem of infections that resist treatment with antibiotics

4. Supporting families to give children and young people the best start in life, through working with health visiting and school nursing, family nurse partnerships and the Troubled Families programme

5. Improving health in the workplace by encouraging employers to support their staff, and those moving into and out of the workforce, to lead healthier lives

Our Priorities

To underpin these outcome-focused priorities we will:

6. Promote the development of place-based public health systems

7. Develop our own capacity and capability to provide professional, scientific and delivery expertise to our partners

Section 7A Agreement

The national public health system

Public Health England

The Department of Health

will set the legal and policy framework, secure resources and make sure public health is central to the Government’s priorities.

The PHE-NHSCBPartnership Agreement

Executive Agency

Chief Medical Officer

http://www.local.gov.uk/home

8 Knowledge and Intelligence Hubs•London•South West•South East•West Midlands•East Midlands•North West•Yorkshire and Humber•North East

Other local presence•Ten microbiology laboratories•Field epidemiology teams•Centre for Radiation Control units

The local and regional presence

Public health advice

People and communities

Health and wellbeing boardsHealth and wellbeing boards

Local governmentLocal government CCGs & their support

CCGs & their support

PHEcentre

NHSCB area team

NHS & IS Providers

3rd sector providers

Commissioner of public health services

Sources of public health advice in the ‘Place-based’ approach to local public health

PHE provides expert advice to local government

DsPH have influence across all local government spend

PHE provides expertise in local area teams

Embedding ‘making every contact count’

Leverage from the public health ringfence

Influence on wider spending

in commercial and voluntary sectors

Clinical Commissioning

Groupsand

Centres for Public Health England:The One-Stop Shop

The PHE Centre is a full partner in the local public health system whose unique role is to provide an agreed range of services and expert advice that is tailored to meet the local needs, wishes and aspirations of local government and the local NHS.

The Centre is the “front-door” of PHE – it is not the only route through which PHE will work with local partners but it is responsible for assuring that services provided by PHE to the locality are agreed and meet local needs.

CVD Mortality <75 Gaps for former Spearhead* authoritiesrelative to the England averages: 1995/7 - 2009/11

0

5

10

15

20

25

30

35

40

45

50

95-97 96-98 97-99 98-00 99-01 00-02 01-03 02-04 03-05 04-06 05-07 06-08 07-09 08-10 09-11three years pooled

abso

lute

gap

in <

75 s

tand

ardi

sed

mor

talit

y

male gap post census

40% gap reduction target male

female gap post census

40% gap reduction target female

Can PH action reduce inequality?

Success in reducing infant mortality

4.03 - Mortality rate from causes considered preventable (provisional)

Age-standardised mortality rate from causes considered preventable per 100,000 population

England 146.1

Yorkshire and The Humber 159.4

Kingston upon Hull, City of 221.0

Doncaster 175.0

North East Lincolnshire 171.9

Leeds 170.1

Bradford 169.5

Calderdale 169.2

Barnsley 167.4

Wakefield 166.7

North Lincolnshire 160.1

Rotherham 159.8

Kirklees 155.6

Sheffield 155.3

York 139.7

East Riding of Yorkshire 133.1

North Yorkshire CC 130.6

Source: Public Health Outcomes Framework (based on ONS source data)

Note this is not the same as the overall premature deaths found in Longer Lives

0 50 100 150 200 250

Preventable Mortality in YH

4.05i - Under 75 mortality rate from cancer (provisional) 2009 - 2011

Age-standardised rate of mortality in persons less than 75 years per 100,000 population with 95% CIs

England 108.1



Barnsley 128.9

Doncaster 128.7

Rotherham 124.1

Wakefield 121.7

Calderdale 120.3


Sheffield 116.9

Leeds 116.1


Bradford 112.8

Kirklees 110.6

York 107.8




0 50 100 150 200

Deaths from Cancers

4.06i - Under 75 mortality rate from liver disease (provisional) 2009 - 2011

Age-standardised rate of mortality in persons less than 75 years per 100,000 population with 95% CIs

England 14.4



Kirklees 18.3

Leeds 17.9

Bradford 17.4

Doncaster 17.1


Calderdale 16.0

Rotherham 15.7

Wakefield 15.3

Sheffield 14.0


Barnsley 13.3


York 10.8



0 5 10 15 20 25

Liver Disease

4.01 - Infant mortality 2009 - 2011

Infant deaths under 1 year of age per 1000 live births with 95% CIs

England 4.3


Bradford 7.4

Calderdale 7.1

Kirklees 5.3

Wakefield 5.0

Sheffield 4.9


York 4.7

Leeds 4.6


Doncaster 4.6

Rotherham 4.5

Barnsley 4.1





0 2 4 6 8 10

Infant Deaths

Variation in TB incidence within Y & H

What does this mean for the PHE Centre in Yorkshire and the Humber?

We need to work out how we will balance local and national priorities for public health.

This doesn’t mean that we simply arbitrate or act as a go between.

Our skill will be to build in the areas where there are uncertainties are gaps.

Making it local

• Health and wellbeing boards

• Local Strategic Partnerships

• Crime and Disorder Reduction Partnerships

• Safeguarding Boards

• Voluntary Service Councils

• LRFs/LHRPs

• Drug and alcohol groups

• TB, Tobacco, Education, Physical activity, Air quality, Housing renewal,…….

Supportive Friendships

The local public health system

Physical Environment

Health Related Behaviour.

Safe and Friendly Neighbourhoods

Attractive Cycle RoutesAnd Pleasant Parks

Social Capital

public health in yorkshire and the humber

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