The Mayors Health Inequalities Strategy Laura Austin Croft Greater - - PowerPoint PPT Presentation

The Mayor’s Health Inequalities Strategy

Laura Austin Croft Greater London Authority laura.austincroft@london.gov.uk 21 October 2014

Presentation outline:

• 1. Health inequalities in London
• 2. The Mayor’s Health Inequalities Strategy and

its delivery plan refresh

• 3. The London Health Commission

recommendations to the Mayor

• 4. Questions

Health Inequalities

• Differences in health between social groups or

populations.

• Interaction of factors make health inequalities

complex

Demographic Social Environmental Political Economical Behavioural Categories of factors that can result in health inequalities

What makes a difference to our health

Socio-economic determinants of health – London

Compared to England, London:

• Has a higher unemployment rate but more young

people in employment, education and training

• Performs slightly better across most economic

security indicators

• Performs worse across all housing indicators
• Has lower rates of depression and hospital

admissions for self-harm

• More low birth weight babies and a significantly

higher rate of tuberculosis

Child poverty in London

• Child poverty levels in London are a third higher

than in England overall: 27% of London’s children live in families who are below the poverty line, versus 20% nationally.

• Levels of child poverty in the poorest boroughs

are nearly five times those of the wealthiest.

• Just 53% of London’s five-year-olds reach a good

level of development at this age.

• Highest rate of childhood obesity of any major

global city

The Mayor’s Health Inequalities Strategy (2010)

Five strategic objectives

• Empowering individuals and communities
• Equitable access to high quality health and social care

services

• Income inequality and health
• Health and employment
• Healthy places

Taken forward by influence, working collaboratively with

• thers and sharing expertise.

http://www.london.gov.uk/priorities/health/tackling- inequality

Recognise the work we have done to date (and its strengths) Describe the new health and social care landscape and

• pportunities for reducing health inequalities

Developing a way of describing and tracking HI over time Respond to the London Health Commission recommendations – where the Mayor is best placed for strategic leadership

HIS delivery plan 2015-2016

Achievements from the first few years of Strategy delivery Identifying a pattern of what the GLA can uniquely do (and the breadth of action) Part of the narrative that supports the delivery refresh (i.e. what we are going to build on going forwards…)

Delivery to date

Six delivery strengths

Strength Example

• 1. Coordinating collaborative

action

Well London, Healthy Schools, Healthy Workplaces, Volunteering

• 2. Instigating pan London

leadership

The London Health Board; the London Health Commission

• 3. Building the case for

action

The economic case for investing in early years; The invisible cost of mental health

• 4. Communication

campaigns

HIV national testing week; cancer awareness pop up shops; World Mental Health day

• 5. Integrating action across

plans and strategies

Improving the health of Londoners transport action plan; influencing the Strategic Planning Guidance of the London Plan

• 6. Highlighting the health

needs of vulnerable groups

Commissioning healthcare support for rough sleepers; children leaving care in the Mayor’s education plan

The new health and social care landscape

Highlights new duties on reducing health inequalities Updates the role of the GLA and its scope for reducing health inequalities across London Supports conversation about how the new duties are being/can be used to support a reduction in health inequalities

Levers for reducing health inequalities

Other: Social Value Act 2013; Equality Duty Act 2010

Health inequalities in London

Local authorities Health and well-being boards; Joint Strategic Needs Assessments; Health and well-being strategies Clinical commissioning groups & NHS providers Access, outcomes, integration of services Public Health England Public Health Outcomes Framework; PHE- London. GLA and the GLA Group TfL; London Enterprise Panel; London Housing Board; London Plan; London Health Board; Mayor’s Office for Policing and Crime.

Indicators need to be…

1. Meaningful to stakeholders in terms of relevant health issues and determinants 2. Easy to understand and to communicate to a range of health and non-health stakeholders, and to the general public 3. Relevant to the rapidly changing and future policy context 4. Span the life-course for London’s population 5. Able to be tracked over time 6. Useful as levers for action within regional & local authorities 7. Uses the most accurate and valid data sources, available for both London as a whole, and for London borough levels, collected on an annual basis 8. Manageable in number i.e. maximum of 12.

Indicators for health inequalities – Plan so far

Conception Birth Childhood and Adolescence Working age Older age

• 1. ‘Late’

antenatal care

NHS England

• 2. School

Readiness

PHOF

3. Educational achievement

Department for Education

• 6. Statutory

Homelessness

Department for Communities and Local Government

• 8. RTC rate based on exposure

Transport for London

• 9. Self-reported well-

being

Office for National Statistics

AND

• 11. Slope Index of Inequality for Life

Expectancy

PHOF

4. London Living Wage

Office for National Statistics

5. Unemployment rates

Department for Work and Pensions

• 10. Healthy Life

Expectancy

PHOF

AND

• 7. Influenza

vaccination

Public Health England

Indicators in more detail

Indicator Explanation ‘Late’ antenatal care

Reducing the % of women who access maternity services later in pregnancy will help to reduce the health inequalities these groups face.

School readiness

Readily available and key measure of early year’s development across a wide range of developmental areas.

Educational achievement

Educational qualifications are a determinant of an individual's labour market position, which in turn influences income, housing and other material resources.

London Living Wage

Tackling low pay has a positive impact on individuals and their families’ health.

Statutory homelessness

This measure counts some of the most vulnerable members of our communities.

Road traffic casualties

This highlights deaths and serious injuries in those people walking, cycling or riding motorbikes, which helps us to understand whether a place is safe and healthy.

London Health Commission recommendations

• R13. Health and care commissioners should jointly

develop a new model to improve support for parents of vulnerable children under 3 yrs old.

• R14. Mayor use the ‘London Plan’ to protect

children from junk food

• R15. Work with Ofsted to ensure more data is

published on school health and well-being

• R16. Address the variation in quality of care for

children

www.londonhealthcommission.org.uk

Next steps

1) Mayor responds to the LHC commission recommendations (end of 2014) 2) Stakeholder engagement on the HIS delivery plan summarised and changes made 3) Delivery plan sent to the London Assembly 4) Delivery plan published (early 2015)