Public Health Annual Report 2014

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CHANGE THE WAY YOU THINK Kirklees Director of Public Health Annual Report - 2014 Contents Foreword 3 Executive Summary 4 Introduction 14 Chapter 1 19 How life has changed: Public health challenges in the 1900s vs the 2000s… how much and how little has changed Infant deaths across the 20th century 19 Infectious diseases then and now 27 The Dewsbury smallpox epidemic in 1904 27 What happened in 2009 with the world wide pandemic of swine flu? 31 References 34 Chapter 2 36 Helping ourselves to better health and well being What is resilience 36 Building your own resilience 43 Building community resilience 45 What needs to change locally to build/enhance personal resilience? 46 Building resilience through self care 52 What usually happens with people who have chronic pain? 62 Recommendations 67 References 68 Chapter 3 71 Working across the whole of the health and wellbeing rainbow So what do we need to think about in taking action to improve local health and wellbeing 71 and reduce inequalities? Creating a Kirklees food culture that is good for people, places, health and the environment 74 The best start in life 83 Helping people find good jobs and stay in work 90 Health and spatial planning 95 Active and safe travel 97 Warmer and safer homes 102 Access to green and open spaces 105 Recommendations 107 References 108 2 Kirklees Director of Public Health Annual Report - 2014 - Change the way you think Foreword Welcome to the 2013/14 Public Health Annual Report for Kirklees. All Directors of Public Health are required to produce an independent annual report on the health of their population, highlighting key issues. In recent years the Joint Strategic Needs Assessment has provided that annual information. This year, Dr Judith Hooper, Kirklees Director of Public Health, has produced a separate Annual Report to focus attention on the Joint Health and Wellbeing and Economic Strategies, which are interlinked, in that both strategies focus on building resilience in people, communities and businesses, in order to increase independence. These strategies are of crucial importance in seeking to make Kirklees a better place in the future i.e. healthy people enjoying a greater quality of life for longer via a strong and growing economy. This focus is particularly important when set against a background of decreasing resources. The recommendations in this report address the organisational and personal challenges across a wide range of factors and subjects. For all who are passionate about better public health: elected members, the Chief Executive and Directors, Health partners, the Local Authority’s and Health’s workforces, we need to do all we can to make public health everyone’s business. Dr Judith Hooper has provided us with a report with a thoughtful direction for the future, which highlights the need to build capacity, by building confidence and resilience in our communities. I would like to acknowledge the work of Dr Hooper, who has had a long and successful career and now approaches retirement, and particularly thank her for her valued insight, leadership and support. Cllr Viv Kendrick Chair, Kirklees Health and Wellbeing Board ? ? ? Kirklees Director of Public Health Annual Report - 2014 - Change the way you think 3 Executive summary This report continues the long tradition of public 3. Have a safe, warm, affordable home in a decent reports on the state of local health by the Medical physical environment in a supportive community. Officers of Health (latterly the Director of Public 4. Take up opportunities that have a positive impact Health) to the Council, partners and local people. on their health and wellbeing. Since 2007 in Kirklees, such reports have been published as Joint Strategic Needs Assessments. We are building a coherent way of working and action plan between the JHWS and the Kirklees Economic This, my last report as DPH, is very different. Strategy (KES) to achieve: I hope to inspire Kirklees to become more resilient and thus healthier by sharing concepts and what is Thriving local communities, growing local businesses, known to work with local examples. high prosperity and low inequality - where local people enjoy better health throughout their lives. Given the challenges facing the public sector in rising levels of need, expectations and shrinking This report contributes to the implementation of the resources there is a real need to rethink the JHWS and the KES by presenting some important relationship between the state and the citizen. This concepts and what we can do locally to achieve those report is a contribution to that rethinking in two very outcomes. different ways: 1. To give a framework for building capacity for adapting to change as positively as possible, whether as individuals, groups of people forming communities or organisations of people working together. This builds confidence and thus resilience. Dr Judith Hooper, Director of Public Health 2. To give road maps of what we can do in Kirklees September 2014 to have a real and extensive impact on the health and wellbeing of local people. Starting with What is health and wellbeing? building resilience across three levels I then review all aspects of daily living from the food I start by reiterating that health is a resource for we eat, the transport we use, the planning of our daily living, which enables us to carry out our environment. This is to help all of us whether daily tasks, socialise, be physically active, cope citizens or in the public sector or working emotionally with life and bodily pain. Wellbeing is our elsewhere to rethink what can I do to improve sense of mental and social functioning at a moment the health of myself, my family, my community, in time. This is both internal to me and how I feel the people I serve, the place I work. So we can all my life compares with others according to social create and take up opportunities to improve local norms. There are a wide range of factors that affect health. our health and wellbeing, as shown by the Rainbow diagram, from genetic makeup through norms of The 2014 Joint Health and Wellbeing Strategy is behaviour to the wider contexts of life.Underpinning to improve local health and wellbeing and reduce our health and wellbeing is how able we are to adapt inequalities no matter where they live. So that local in the face of adversity and carry on “normally” i.e. people can: our resilience. 1. Control and manage life challenges by being resilient, feeling safe and positively included. 2. Navigate through life: being able to participate and contribute to the community. 4 Kirklees Director of Public Health Annual Report - 2014 - Change the way you think Chapter 1 How life has changed: Public health challenges in the 1900s vs the 2000s…how much and how little has changed Of course the world we now live in is so different to During my time as the DPH for Kirklees since 2002, 100 years ago. In this context key differences such 2 major challenges to tackle have been the tragedies as people’s expectations of the health service and its of infant deaths and the Influenza pandemic of 2009, ability to respond as well as that of other agencies; specifically in the local major outbreak that occurred access to advice from ‘experts’ with conflicting points of in Dewsbury. I have reviewed these against reports of view on topics such as infant nutrition and weaning, all these same challenges in the 1900s. of which present a modern challenge compared to the 1900s when there was a single voice of ‘authority’. Of “Great progress has been made during the last 50 course there are changes in most of the content of the years (since the 1900s) in the reduction of infant deaths, conversations between the health visitor and the local and this progress has not been brought about by any mothers and the environment they live in. However, in single scientific discovery or social reform, but more thinking about the nature of those conversations, both by a combination of factors…if one of these factors scenarios emphasise the overwhelming importance may be emphasised more than another it is the steady of working with local people to understand where they improvement through the years in the education of are coming from, what they are thinking, what their the mother in the feeding and care of her child. In this priorities are across their rainbows and support them improvement…the work of the ’Health Visitors‘ has played in being as positive as they can be in making as healthy an important part.” Medical Officer of Health 1950s a choice for them and their families as possible. While the rate of the tragedies of infant deaths in Batley “Clearly there are many factors affecting the health of and Dewsbury has not fallen to the national level as yet, the pregnant woman and her baby. Some can be changed it is declining but we still need to support the families and some cannot. Of course access to good quality in north Kirklees to have as healthy pregnancy, birth support and care is crucial but so is how we cope with and infancy as possible by working with them. our lives. In how we deal with life’s challenges we are heavily influenced by the world we have been brought up in, the relationships we have and the security we feel in ourselves. All of this gives us the resources to be resilient or not i.e. our ability to adapt and manage changes”. Director of Public Health 2014 ? Kirklees Director of Public Health Annual Report - 2014 - Change the way you think 5 Chapter 2 Helping ourselves to better health and wellbeing: what can we do and what help do we need from others? Being personally resilient means adapting in the face of adversity compassionately and continuing to function “normally.” It includes letting go, learning and growing as well as finding healthy ways to cope.

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