ukphr consultative forum 5 th november 2015 dr anne kilgallen
TRANSCRIPT
UKPHRConsultative Forum 5th November 2015
Dr Anne Kilgallen
Welcome to Northern Ireland
This morning I shall discuss....
• The Major Public Health Challenges Facing the People of Northern Ireland
• Our strategies to improve health• Brief reflections on implications for
workforce development and capacity building
Dr Samuel Browne
Health Challenges for NI • Demographic – ageing population -
growth in chronic conditions• Higher rates of preventable illness and
premature deaths in most deprived areas
• Correlations with wider determinants such as educational attainment
• “At risk”/vulnerable groups
Life expectancy in Northern Ireland
30
40
50
60
70
80
90
Ag
e
Male
Female
50
55
60
65
70
75
80
85
90
Most dep 3 5 7 9
Year
s
Deprivation decile
Males
Females
Linear (Males)
Linear (Females)
Life expectancy by Deprivation Northern Ireland 2008‐10
Life expectancy at selected points along a Belfast Metro bus line (2006-08)
Health Inequalities - General• Average male life expectancy is now 77.5 years (2009/11), and female life expectancy is
82.0
• In the same period the gender gap in life expectancy has decreased by 2 years to 4.4 years
• Coronary heart disease, cancer and respiratory disease continue to be the main causes of death for both sexes
• There is a notable increase in death rates from cancer, CHD and respiratory disease as level of deprivation increases
• Health surveys show that respondents in more deprived areas are less likely to meet the lifestyle choice recommendations when compared with those in less deprived areas
Smoking prevalence
1998
/99
2000
/01
2002
/03
2004
/05
2006
/07
2007
/08
2008
/09
2009
/10
2010
/11
2011
/12
2012
/13
0
5
10
15
20
25
30
35
40
Smoking Prevalence Northern Ireland 1998/99-2010/11
All Adults
Manual Workers
Year
Per
cen
tag
e
Smoking and health inequalities
Profe
ssion
al
Emplo
yer,
Man
ager
Inte
rmed
iate
non-
man
ual
Junio
r non
-man
ual
Skilled
man
ual
Semi-s
killed
man
ual
Unskil
led m
anua
l0
10
20
30
40
50
60
1983 2012/13
Socio-economic group
Per
cen
tag
e o
f sm
oke
rs
Prevalence of Obesity
Health Survey Northern Ireland (HSNI) 2013/14 • Adults - 61% of adults were either overweight
(37%) or obese (24%).
• Children - These findings use International Obesity Task Force (IOTF) cut-off points of the BMI percentiles for children aged 2-15 years of age.
• 17% of children aged 2-15 were classed as overweight and 7% were classed as obese.
Obesogenic Environment
Overweight and Obesity and other risk
factors
Increased risk of associated health conditions:
· Type II Diabetes· Heart disease/stroke
Physical inactivity and unhealthy eating (and other
risk factors)
Individual Factors· Knowledge· Skills and habits· Attitudes· Psychological factors
Social Factors· Educational level· Socioeconomic status – poverty,
health inequalities
Environmental FactorsAffecting the behaviour of the individual
· Portion sizes· Ready Access (vending machines)· Physical activity opportunities (green
spaces)· Occupational inactivity
Immutable factors· sex· age · genetics
Trends in diagnoses made in Northern Ireland GUM Clinics, 2000-2014
Table 2: New diagnoses of HIV and AIDS in Northern Ireland, by year of diagnosis, and deaths in HIV-infected individuals, by year of death
Alcohol related hospital admissions by deprivation
Alcohol related hospital admissions per 1,000 population(2007/8 - 2009/10)
0
5
10
15
20
25
30
35
40
Mostdeprived
Quintile 2 Quintile 3 Quintile 4 Leastdeprived
(Alcohol related admissions are here defined as the same causes as for alcohol related deaths)
Stan
dard
ised
Adm
issi
on R
ate
per 1
,000
pop
ulati
on
Male
Female
NI
% Difference from the NI average Suicide rate by economic deprivation
Percentage difference from the NI average rate for suicide by geographic proxy for economic deprivation
-20%
0%
20%
40%
60%
80%
100%
2000-04 2001-05 2002-06 2003-07 2004-08 2005-09
NI average = 0%
Economic deprivedareas
Not deprived areas
Economic deprivation domain: 2005
WIDER DETERMINANTS
More than 1 in 5 children growing up below the poverty line42% of households in fuel poverty Unemployment rate 6.0 %:
Rate for 18-24 yr olds 28%Long Term unemployed 59% of the total unemployed
A WHOLE SYSTEM STRATEGIC FRAMEWORK FOR PUBLIC HEALTH
2013 - 2023
Vision and Aims
All people are enabled and supported in achieving their full health and wellbeing potential.
The aims are to achieve better health and wellbeing for everyone and reduce inequalities in health.
Key Features
• High level/strategic/cross – cutting
• Collaboration, engagement and empowerment
• Thematic approach - wider determinants and lifecourse
• Outcomes and supporting actions
• The social gradient – proportionate universalism
• Whole system approach
Values
• Social justice, equity and inclusion
• Engagement and Empowerment
• Collaboration
• Evidence informed
• Addressing local need
Making Life Better - Themes
• Giving Every Child the Best Start
• Equipped throughout Life
• Empowering Healthy Living
• Creating the Conditions
• Empowering Communities
• Developing Collaboration
Making it Work
Challenges for The Public Health Function
• Ensuring we have the capacity to meet our public health challenges across the three domains.
• Ensuring we continue to have a highly skilled specialist workforce to meet our needs
• Ensuring we develop specialists from disciplines other than medicine
Challenges for the Public Health Function
• Ensuring closer working across the devolved administrations and Ireland
• Developing our wider public health workforce within the HSC and beyond
Thank You