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Are We Moving in the Right Direction

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Are We Moving in the Right Direction Glasgow Health & Wellbeing Indicators Event Thursday 4th February 2010 Boardroom, GCPH, 94 Elmbank St, Glasgow 1 Contents Page 1. Delegate List 3 2. Introduction and overview 4 3. Summary of presentations 4 Gail Findlay, London Health Commission Grant Pettitt, London Health Commission Bruce Whyte, Glasgow Centre for Population Health Andrew Lyon, International Futures Forum 4. Discussion on themes: 11 Framework and possible indicators What contribution could you or your organisation make Feedback 5. Conclusions and next steps 12 Appendix 1: Workshop notes 13 Appendix 2: Seminar programme 19 2 1. Delegate List Attendees Name Organisation James Arnott Glasgow City Council – Development and Regeneration Services Jane Arthur Glasgow City Council – Education, Strategic Health Promotion and Improvement Working Group Kay Barton Scottish Government Sandy Bennett Glasgow City Council - Land and Environmental Services Duncan Booker Glasgow City Council – Chief Executive’s Office George Black Glasgow City Council – Chief Executive’s Office Linda de Caestecker NHS Greater Glasgow and Clyde Sandra Carlisle University of Glasgow Dawn Corbett Glasgow City Council – Chief Executive’s Office Lynda Campbell Glasgow Life Fiona Crawford Glasgow Centre for Population Health Rosalind Deans NHS Greater Glasgow and Clyde Nic Dickson Glasgow Life Gail Findlay London Health Commission Darren Keenan Glasgow City Council – Chief Executive’s Office Peter Kelly The Poverty Alliance Andrew Lyon International Futures Forum Chris Mooney Community Safety Partnership James McCormick Joseph Rowntree Foundation John McLaren Centre for Public Policy for the Regions Ian Nicol NHS Greater Glasgow and Clyde Mark O’Neill Glasgow Life Paola Pasino Glasgow City Council – Development and Regeneration Services Grant Pettitt London Health Commission Carol Tannahill Glasgow Centre for Population Health Bruce Whyte Glasgow Centre for Population Health Apologies Name Organisation Chris Brodie Slims Consulting Helen MacNeil Glasgow Council for Voluntary Organisations Catriona Renfrew NHS Greater Glasgow and Clyde 3 2. Introduction and overview This event was held to develop thinking about the possible format, content and aims for a set of Health and Wellbeing (HWB) indicators for Glasgow. The impetus for developing this work has come from responses to the City Economic Strategy (2007) and the Health Commission’s report, Growing a Healthier Glasgow (2009), and, in particular, the desire to be able to track progress on a set of key strategic indicators. An important aim of the event was to open up the discussion on how to develop HWB indicators and to encourage support for this initiative. This report summarises the presentations and discussions from this first event, and points towards ways forward for developing a practical set of HWB indicators within a relatively short timescale. 3. Summary of presentations Following the introductions by George Black and Carol Tannahill there were presentations by Gail Findlay (London Health Commission) and Grant Pettitt (Greater London Authority), Bruce Whyte of the Glasgow Centre for Population Health, and Andrew Lyon of the International Futures Forum. Gail Findlay began by describing how the London Health Commission was launched in October 2000, with the aim and purpose to “galvanise leadership across London to reduce health inequalities and to improve the health of all Londoners”. The ten high level indicators chosen by the Commission were:- Unemployment Ethnicity and Unemployment Educational Attainment Unfit Homes Domestic Burglary Air Quality Road Traffic Accidents Life Expectancy Infant Mortality Self Assessed good health By measuring these indicators inequalities were uncovered geographically and by population group (an example of which is illustrated in Figure 1) and this has led to implications for action, such as improving health intelligence, moving from evidence to policy to action and increasing understanding. 4 Map 7: Percentage of 15 year olds achieving 5 or more GCSEs at grades A*-C, 2003/04 London Health Commission map showing inequality in educational achievement by London borough The Health in London Report publishes these data annually and the report is then used as an essential resource/handbook by LHC Commissioners, LHC Forums, partner organisations, policymakers and analysts to inform and assist with decision making. Gail also touched on the impact of the Health Commission which (although difficult to separate from other factors) is thought to have assisted with keeping the spotlight on health inequalities since its inception. Grant Pettit followed on by describing the London Health Inequalities Strategy draft for public consultation (2009). He began by using a version of the Intersectoral action for Health WHO 1986 diagrams showing the challenges faced and the components of success in health inequalities: The Challenge What we are trying to achieve The London Health Inequalities Strategy (HIS) arose out of the HC 2000, GLA 2007. Grant stated that the four high level ambitions for the London Health Inequalities Strategy are to:- Improve the health of all Londoners; promoting both mental and physical well being Reduce the gap between Londoners with the best and worst health outcomes Promote the economic, social and environmental changes that will improve quality of life for all Londoners Empower individuals and communities to take control of their lives and make healthier choices, with a particular focus on the most disadvantaged And the objectives for the London Health Inequalities Strategy were summarised as the following:- 5 1) Empowering individuals and communities to improve health and well being. 2) Improving access to high quality health and social care services. 3) Reducing income inequality and the negative consequences of relative poverty. 4) Increasing the opportunities for people to access the potential benefits of work and other forms of meaningful activity. 5) Developing and promoting London as a healthy place for all. With knowledge and learning as cross-cutting theme. The preliminary stage of selecting indicators for the Health Inequalities Strategy includes work on the evidence base, the development of domains and comparison indicators for London and national/international. Examples of these included the aforementioned London Health Commission Health in London Report (London), the UK Government Sustainable Development Indicators (national) and the WHO Indicators of Healthy Cities or the United Nations Development Group: Common Country Assessment (international). The indicators in the current consultation draft are:- Health Outcomes (e.g. life expectancy, infant mortality) Health Related Behaviours (e.g. smoking prevalence, consumption of fruit & veg) Socio-economic Variables (e.g. employment rate, child poverty) Place and Environmental factors (e.g. crime, area deprivation, air quality) Social Capital and Psych-social factors (e.g. satisfaction with life, volunteering) Access to Healthcare and Health System (e.g. GP access, CBT access, vaccinations) Grant then illustrated how the Health Inequalities Strategy indicators are mapped against Public Service Agreement objectives, Local Area Agreement outcomes and Local Area Agreement National Indicators. He stated that the HIS indicators were not intended as performance management indicators, but instead should be considered as a tool to engage local authorities in the delivery of the strategy and to monitor the effects of programmes on different population groups. Grant concluded by highlighting the links with the Marmot Review set of high level indicators, along with the World Class Commission Inequalities Indicator (which may be adopted by the HIS) and the potential for a London wellbeing indicator. Bruce Whyte continued the focus on indicators by introducing the subject of a framework for health and wellbeing indicators in Glasgow. He set the scene by explaining how certain groups, programmes and reports have already laid the foundations for the development of a set of health and wellbeing indicators for Glasgow, including:- The City Strategy Action plan (2007) Growing a Healthier Glasgow (2009) Community Planning Executive Group GCPH work e.g. o Let Glasgow Flourish o Community Health Profiles o Miniature Glasgow o Comparisons with other European Regions o Culture and Health Bruce also referred to the following ‘determinants of health’ diagram in describing the case for health and wellbeing indicators:- 6 The Case for health and Along with the example of a well-being indicators relevant case study (the Boston indicators project) of which more details can be found at: http://www.bostonindicators.org /Indicators2008/. (Dahlgren, G and Whitehead, M, 1991) In terms of a framework for health and wellbeing indicators for Glasgow, Bruce identified the following key features:- A basket of indicators, rather than one index, representing a dynamic interlinked view of the city Focus on themes that are clear priorities for the city Providing a strategic overview Trends to be monitored over time Inequality, or difference, within the city to be monitored Comparisons to be made to other comparator UK cities and to European cities where possible He then went on to propose specific domains, indicators and their sources, as summarised below: Proposed Indicators Domain Proposed Indicator Source Poverty Children in low-income families HMRC Economic Participation Employment rate NOMIS, Eurostat Education School Attainment Scottish
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