950 Homelessness Prevention .Sarah
Total Page：16
File Type：pdf, Size：1020Kb
Health in a Healthy City The Annual Report of the Director of Public Health 2005 and Brighton and Hove City Health Development Plan CONTENTS Page Contents i Foreword and Contributors ii Executive Summary 1 Chapter 1 Introduction by Tom Scanlon, Acting Director of Public Health 3 Chapter 2 Policy Context 7 2.1 National Policy 8 2.2 International Context 9 2.3 Local Policies and Local Implementation of National Policy 9 Chapter 3 Tackling the Causes of Ill Health 13 3.1 The Determinants of Health 14 3.2 Lifestyle 15 3.3 Poverty 25 3.4 Health and Healthcare 28 3.5 Education and Life-Long Learning 32 3.6 Transport 35 3.7 City Planning 38 3.8 Housing 41 3.9 Crime 44 3.10 Economic Development 47 3.11 Environment 52 3.12 2020 Community Strategy Performance Targets 56 Chapter 4 Involving Local Communities 59 Chapter 5 Healthy City Partnership 63 Chapter 6 Conclusions and Delivery Plan 69 Glossary of Abbreviations 78 References 79 i FOREWORD Foreword Recent years have seen greater ties and co-operation between the many partners in Brighton and Hove who contribute to health improvement and to the reduction of inequalities in health. In July 2004, this progress was formally recognised by the World Health Organisation (WHO) with the award of Healthy City status. Designation as a WHO Healthy City requires the production of a City Health Development Plan (CHDP). This year, therefore, the Director of Public Health’s Annual Report 2005 serves also as a City Health Development Plan. The production of the Report and CHDP presented further opportunities to develop the ties and close relationships required of the partners who hold a remit for improving public health. This year’s Report is the second that has been produced jointly between the Primary Care Trust (PCT) and the City Council and reflects an increasingly common agenda between the two organisations. I would like to thank all those who have played their part in putting this Report and Development Plan together; colleagues at the PCT and the City Council, as well as colleagues in the business, community and voluntary sectors. I would like to thank the individuals who took overall responsibility for co-ordinating specific contributions: Bernadette Alves, Kate Benson, Chris Dorling, Henriette Hardiman, Carmel Mullaney, Sarah Nicholls, Sunanda Ray, Peter Wilkinson and Becky Woodiwiss. In particular, I would like to thank Terry Blair-Stevens, Claire Turner and Martina Pickin. Terry, as well as writing a substantial part of the Report and Plan, led on its production, while Claire and Martina took on additional responsibilities in writing and editing to ensure that it was produced on time; all three of them with characteristic dedication, professionalism and good humour. I am confident that the Report and Plan will provide the framework required for delivering the Healthy City agenda and that it will be seen as a credit to all those involved who dedicate themselves to this end. Thank you all. Contributors Bernadette Alves Chris Dorling Lydie Lawrence Andy Renaut Kate Benson Angie Emerson Scott Marshall Tom Scanlon Terry Blair-Stevens Rob Fraser Paul Martin Andy Staniford Gwendolyn Brandon Deborah Georgiou Chris Minter Matthew Thomas Gavin Bryce Henriette Hardiman Carmel Mullaney Liz Tucker Elizabeth Cameron Sarah Hardman Simon Newell Claire Turner Martin Campbell Doreen Harrison Sarah Nicholls Affy Wajid Kerry Clarke Nick Hibberd Caron Patmore Andrew Wilson Ruth Condon Louise Hulton Martina Pickin Chris Wilson Rachel Conway Paul Jarvis Hilary Powlson Peter Wilkinson Thurstan Crockett Jackie Johnson Sunanda Ray Becky Woodiwiss Gillian Cunliffe Carol King Julia Reddaway THE ANNUAL REPORT OF THE DIRECTOR OF PUBLIC HEALTH 2005 AND CITY HEALTH DEVELOPMENT PLAN ii EXECUTIVE SUMMARY Executive Summary Although there have been major improvements with recommendations as to how performance in health and life expectancy over time, the might be improved. Chapter 3 comprises experience of ill-health, disability and premature contributions on lifestyle, poverty, health and mortality is highly unequal between gender, healthcare, education, transport, city planning, ethnic group and socio-economic group. housing, crime, the economy and employment, Poverty, low wages and occupational stress, and the environment. The lifestyle section unemployment, poor housing, environmental within Chapter 3 includes a summary delivery pollution, poor education, limited access plan for the Public Health White Paper. The to transport and shops, crime and disorder, chapter concludes with a summary of progress and a lack of recreational facilities all impact against 2020 Community Strategy targets. on people’s health. Chapter 4 outlines the progress that has been Improving health and tackling health inequalities made in addressing community involvement on is a priority for the present Government. a number of fronts through neighbourhood A comprehensive cross-government programme renewal, New Deal for Communities (eb4U), of national policies and targets has been Healthy City status, the Local Area Agreement developed to address this, and targets and and with specific groups such as older people standards for local action have been set. and children. A local Health Inequalities Strategy, A Strategy The process for monitoring progress as a to Reduce Health Inequalities in Brighton & Healthy City is summarised in Chapter 5. Hove, outlines the local response to these The Report finishes with a concluding chapter inequalities (Scanlon, 2005). which includes a programme for delivering This Annual Report of the Director of Public the City Health Development Plan. This Health for Brighton and Hove 2005 is the delivery plan describes the key partnership second joint Primary Care Trust (PCT) and City arrangements for coordinating healthy city Council public health report. First and foremost, development, strategic objectives, actions, the Report serves as a City Health Development milestones and the resources necessary to Plan as part of the city’s commitments as a deliver the recommendations from this Report. WHO Healthy City. The Report also includes The worst health problems in the city will proposed actions to address the Public Health not be overcome unless the root causes of White Paper Choosing Health: making healthier ill health and inequalities in health are tackled. choices easier, and it summarises the progress There is a need, therefore, for targeting that has been made against the 2020 measures across employment, education, Community Strategy. housing, transport, the environment, the Following the introduction, Chapter 2 economy, crime and safety all of which have summarises the policy context for the Report an impact on health. This agenda can only in the light of the city’s designation as a WHO be addressed by building strong partnerships Healthy City. Chapter 3, which forms the bulk that include communities. Healthy City status of the Report, considers the wider determinants offers Brighton and Hove a unique opportunity, of health in a systematic way, outlining the and a vehicle for statutory and non-statutory evidence for their contribution to health and organisations and the community to come health inequalities, relevant national and local together and unite in making Brighton and policies, how Brighton and Hove has performed Hove a much healthier place for everyone. against targets or standards and concluding THE ANNUAL REPORT OF THE DIRECTOR OF PUBLIC HEALTH 2005 AND CITY HEALTH DEVELOPMENT PLAN 1 2 CHAPTER ONE INTRODUCTION BY TOM SCANLON, ACTING DIRECTOR OF PUBLIC HEALTH CHAPTER 1 INTRODUCTION Introduction Good health is the result of much more than knowledge, skills and experience can help plan medical care. Living and working conditions and develop services. Community participation determine people’s health. This includes the requires a genuine commitment to openness, physical, social and economic environment as flexibility and accountability. well as the quality and accessibility of health The vision for Brighton and Hove as a Healthy and social care services. People are healthier City is outlined in the Healthy City Partnership’s still when they live in nurturing environments Declaration on Health 2004. The people of and are involved in the life of their community. Brighton and Hove have the right to expect This Annual Report of the Director of Public Health the best possible health and quality of life for serves this year also as a City Health Development themselves and generations to come. Everyone Plan (CHDP). This CHDP has been put together needs to take responsibility and work together as a requirement of membership of the WHO to achieve this. This means getting involved Healthy Cities Project. This accolade awarded to individually to influence policy and decisions, Brighton and Hove in July 2004 is an and taking personal responsibility for acknowledgement of the high standard of strategic behaviours and lifestyles. Most importantly, planning, partnership and political commitment it means working collectively to combine skills for health improvement across the city. and resources to assist those who face the biggest challenges in achieving good health. The Report shows how health is influenced by the conditions in which the residents of Brighton The Healthy City Partnership is the group that and Hove live and presents an overview of the leads the Healthy City Work Programme. The success or failure of much of the work that is Partnership directs the actions required for currently being carried out locally