International Festival of Public Health

LT 2 - Health Promotion and Improvement

Integrating Wellbeing and Welfare provision to address the wider determinants of health in Salford

Presenter: Angela Eden (Salford City Council)

Other Author(s): Peter Locke

Abstract Text:

Aims: Within the context of national welfare reform and an increasing impact from poverty and austerity measures, the Health Improvement Service has developed an integrated offer to encompass both wellbeing and welfare to provide holistic, person centred support.

Design: There are a number of different interventions happening simultaneously as part of this innovation including: 1.Organisational development across the Adult Services within the City Council 2.Outreach and engagement campaigns within socio-economically deprived communities in Salford focused around anti-poverty 3.Engagement with GPs and primary care to provide a single access point into Wellbeing and Welfare 4.The provision of one to one, person centred support using social prescribing methodology. Setting: Salford, North West England. Participants: Any Salford residents requiring support to make lifestyle changes, to become more involved in social networks, or financial support.

Results: This is an ongoing area of development, so far the following results have been achieved: •Close, collaborative working, and a joined up approach between Health Improvement Service, Salford Assist, Welfare Rights and Debt Advice services, Housing and Homeless Services. •Two collaborative anti-poverty outreach and engagement campaigns delivered within target areas of the city. One, to promote access to the welfare support available for those in need. Two, to promote access to the Pension Credit benefit before further reform takes place. •Delivered a briefing session to all GP practices across the city in relation to the Wellbeing and Welfare service offer and how to access this. Also established social prescribing schemes in 9 practices across the city. •Supported 1132 patients through the Wellbeing and Welfare social prescribing pathway to achieve a range of social, wellbeing and lifestyle related outcomes

Conclusion: Poverty and poor health are inextricably linked. The causes of poor health are commonly rooted in social, economic and political factors where by poverty is both a cause and a consequence of poor health. This programme of work has been developed in an attempt to negate some of the consequences of national policy and welfare reform. It is a move towards reconnecting public health with the wider determinants of health to tackle to genuine root causes of ill health taking a holistic approach. This is an ongoing programme of work.

Helping people to stop smoking with free e-cigarettes

Presenter: Ben Fryer (North West School of Public Health)

Other Author(s): -

Abstract Text:

Introduction: Trafford has a relatively low smoking rate (12.7%), but a high smoking rate for specific population groups, including routine and manual workers (26.8%) and adults with serious mental illness (42.1%). This gives rise to significant health inequalities. Trafford does not have a specialist stop smoking service, but the council commissions smoking cessation services from pharmacies and GP practices. This has delivered very small numbers of quitters (only 50 per year) at a very high cost.

Method: Following a successful pilot in Salford, we developed an innovative smoking cessation service for Trafford residents using free e-cigarettes, delivered in pharmacies. This is running as a pilot from January to June 2019. The pilot is open to all smokers aged 18+, but pharmacies have been selected to enable us to reach routine and manual workers to address health inequalities. We are aiming to enrol up to 800 participants. A detailed mixed-methods evaluation of the pilot including secondary data analysis and qualitative research will be commissioned.

Results: Our primary outcome is the quit rate (%) at 4 weeks after each client’s quit date. We will record number of cigarettes smoked and a CO reading before and after participation for secondary outcomes. We will also collect demographic information including occupational status, ethnicity and IMD to enable monitoring of health equity. Provisional results of the pilot will be available during the International Festival of Public Health.

Rising levels of childhood obesity and widening socioeconomic inequalities: Where are we going wrong?

Presenter: Rob Noonan (University of Liverpool)

Other Author(s): -

Abstract Text:

Purpose: We know that there is a steep social gradient to childhood obesity in England¹, but are socioeconomic inequalities in childhood obesity growing? This study assessed whether childhood obesity rates increased between 2006 and 2012, in Liverpool, the most socially disadvantaged area of England, and examined the extent to which socioeconomic inequalities in childhood obesity in Liverpool changed during this six-year period.

Methods: A sample of 50,125 children was created using data from the National Child Measurement Program (NCMP) in Liverpool. The prevalence of overweight and obesity was calculated for Reception and Year 6 aged children in Liverpool for each time period by gender and compared against published averages for England. Logistic regression analyses examined the likelihood of children in Liverpool being classified as overweight and obese based on deprivation level for each time period. Analyses were conducted separately for Reception and Year 6 aged children and were adjusted for gender.

Results: Obesity rates among Reception and Year 6 aged children in Liverpool increased between 2006 and 2012. During the same period, socioeconomic disparities in obesity rates between children living in the most deprived communities in Liverpool and those living in less deprived communities in Liverpool, widened.

Conclusions: The clear demonstration of a widening in socioeconomic health inequality among children in Liverpool is very significant in view of current ongoing austerity and public health funding cuts across England. A new approach to reducing childhood obesity and tackling socioeconomic health inequalities in England is needed.

Supporting vulnerable young women: Evidence from the voluntary sector

Presenter: Ruth Cross and Louise Warwick-Booth (Leeds Beckett University)

Other Author(s): -

Abstract Text:

Relative disadvantage and deprivation are significant problems for vulnerable young women in urban areas in England. Despite experiencing a range of complex health needs such young women do not often meet the required thresholds for statutory help and are therefore unable to access any. In a climate where statutory support systems are being systematically weakened third sector (or non-governmental) organisations are playing a significant role in supporting young women. This paper will present key findings from several evaluations of third sector projects delivered largely by support workers and volunteers that are designed to make a difference to young women’s lives. The findings cohere around what works and provide a range of evidence of effective approaches to supporting vulnerable young women with complex needs. Based on our findings we have developed a model of women-centred working. This will also be presented and discussed. The implications of the model for policy and practice will be considered. It is anticipated that the lessons learned will be transferable to other contexts.