Representatives
from the Public Health team will be in attendance to provide information about
Health Inequalities from a Public Health perspective.
Minutes:
The Chair welcomed the Advanced Public Health Practitioner to the
meeting and invited her to present information relating to health inequalities.
Members were informed that much of the presentation covered similar themes as
those presented by the TVCCG.
It was reiterated that collaborative working was key to success in
combatting health inequalities. Members were advised that to effectively combat
health inequalities the subject needed to be reframed. To this end health
inequalities should be viewed through the Population Intervention Triangle
which composed of Civic, Service and Community Based Interventions. As part of
those interventions it was noted the most effective actions in reducing
inequalities included structural changes to the environment; income support;
reduced price barriers and intensive support for disadvantaged population
groups.
Conversely, the least effective measures included those whereby people
had to opt-in; information based campaigns and interventions that had
significant cost or travel barriers.
The actions to combat health inequalities were based on the Marmot
recommendations of 2010, the central focus being that disadvantage started
before birth.
Members heard that health inequalities were preventable differences in
health status across the population and that several overlapping factors
contributed to them. Health inequalities were also driven by a complex
interaction between factors including life expectancy; the prevalence of mental
health and experience of health care. These were, in turn, affected by wider
determinants such as education and income levels.
The scale of health inequalities in Middlesbrough, and the determinants
of them, were on a higher scale that the English average. These included lower
life expectancy and variation in life expectancy within Middlesbrough itself.
This situation had been exacerbated by the Covid-19 pandemic.
Public Health was piloting the Health Inequality Impact Assessment which
aimed to embed health inequalities in the planning process. This tool would
help different organisations in their strategic planning and understand the
local health profile of the population. This Impact Assessment was being
piloted in five identified areas and was supported with a strong place-based
partnership with Middlesbrough’s Primary Care Networks.
An example of a strong community based interventions was the Changing
Future Programmes through which South Tees was successful in securing £3.11
million.
This was a high profile national programme that aimed to tackle multiple
vulnerabilities including two or more issues such as substance abuse and mental
health.
In terms of service based interventions; there were numerous
preventative services in place that aimed to address some of the more
significant health inequalities in Middlesbrough, such as those related to
smoking and alcohol misuse. It was important to build equitability into service
design by locating services in hard to engage areas and providing services free
at the point of access.
Members were advised that provided there was sufficient political and
societal will health inequalities could be reduced.
A Member commented that given the breadth and importance of the
information provided it would be prudent for the information to be broken down
and detailed for Members in the future.
A Member commented they were unsure if the political will existed to
tackle health inequalities in the manner identified and queried if the
financial resources available to tackle health inequalities was sufficient. The
Member also queried how emerging issues, such as the ONS publication “Avoidable
mortality in Great Britain” were addressed. It was clarified that collaborative
working may help improve financial resourcing and that the ONS publication was
very recent and further consideration of its contents was required before
action could be taken.
A Member commented that other Council services could indirectly help
combat health inequalities, such as licensing saturation areas that prevented
too many alcohol outlets being created in a specified area. The Member commented that the solution to
health inequalities was not only a matter of increased financial investment,
instead a cultural shift was also required. Public Health commented that
various initiatives were in place that tried to understand people’s behaviours.
The Chair thanked the Advanced Public Health Practitioner for their
attendance.
ORDERED that:
1.
The slides presented be circulated to Members.
2.
That the information presented be noted.