Community Regeneration and Health Improvement Developing an outcomes focused approach

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Community Regeneration and Health Improvement
Developing an outcomes focused approach

• Erica Wimbush
• NHS Health Scotland

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Outline

• Policy drivers
• An outcomes approach to planning and performance
  management
• The potential role of community regeneration in
  delivering health improvement outcomes what can
  be done?
• Community Planning Partnerships what is the
  best approach?

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Policy drivers
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An outcomes approach to planning and performance
management
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Outcome-focused planning performance reporting
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(No Transcript)
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The main determinants of health
Dahlgren Whitehead, 2004
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The planning and delivery infrastructure for
Health Improvement Outcomes
National
COSLA LGIS
SCVOVHS
SCC SFHA
HPS ISD NES QIS
LTS SHPSU
COMMUNITIES SCOTLAND
FSAS
SCDC CHEX
HEALTH SCOTLAND
Regional
14 NHS BOARDS
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The potential role of community regeneration in
delivering HI outcomes What can be done?

• WHO Europe, 2006
• Levelling up (Part 2)
• a discussion paper on European strategies for
• tackling social inequities in health
• Göran Dahlgren and Margaret Whitehead

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Influencing health determinantsWhat can be done?

• Promoting positive health factors for example
• Economic security, adequate housing and food
  security
• Control over life outcomes, good family and
  social relationships
• Strengthening protective factors for example
• Immunization against infectious diseases
  Protection from hazards/community safety Social
  support, sense of purpose and direction in life
  Healthy diet
• Risk factors/conditions for example
• Lifestyle related risk factors smoking,
  excessive drinking and eating
• Social or economic risk factors - poverty, low
  income, unemployment, isolation
• Environmental health hazards, such as air
  pollution, road traffic.

WHO Europe (2006) Levelling Up - Part 2
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Reducing health inequalitiesWhich approach?

• Focusing only on people in poverty or the most
  deprived localities
• Narrowing the health divide
• Reducing social inequities throughout the whole
  population.

WHO Europe (2006) Levelling Up - Part 2
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Economic regenerationWhat can be done?

• Economic growth strategies Health is Wealth
• Potential health benefits of economic growth
• Population health as a determinant of economic
  growth high social and business costs of poor
  health
• Policy options for reducing health inequalities
• Economic growth recognised as a resource for
  human development, esp for disadv groups/areas
• Successful growth reduces poverty and income
  inequalities, improves living conditions, access
  to education and healthcare
• Use human development measures of growth - health
  adjusted measures of GNP, Millennium Dev Goals

WHO Europe (2006) Levelling Up - Part 2
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Getting people into work What can be done?

• Work environment and unemployment
• Positive social aspects of work environment
• Health hazards of work work-related ill-health,
  stress and physical safety still a significant
  factor in burden of disease
• Negative health impacts of unemployment
• Policy options for reducing health inequalities
• Health safety legislation
• Actions that remove physical hazards in the
  workplace and improve psychosocial conditions
• Actions to improve the employability of those out
  of work
• Rehabilitation of those off sick or on incapacity
  benefit
• Develop the workplace as a setting for health
  promotion.

WHO Europe (2006) Levelling Up - Part 2
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Education, learning, skillsWhat can be done?

• Education and health
• Improved health literacy
• Impacts on job opportunities, income level,
  occupational stresses/hazards
• A route out of poverty for disadvantaged groups
  and a channel for social mobility
• Empowerment enabling and encouraging
  participation in the community more control over
  life
• Policy options for reducing health inequalities
• Reduce barriers to gaining access to education
  and life-long learning for disadvantaged groups
• Comprehensive support programmes for children in
  less privileged families, to promote preschool
  development, prevent school drop-out, and support
  the school-work transition
• Reduce social segregation within the school
  system
• Health Promoting Schools

WHO Europe (2006) Levelling Up - Part 2
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Environmental regenerationWhat can be done?

• Environment and health
• Housing quality, overcrowding, homelessness,
  thermal efficiency, child safety
• Security/safety mental health injuries from
  crime, violence and disorder
• Transport/roads mobility/access to services,
  road deaths and injuries
• Access to green space mental health and
  physical activity benefits

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Social regenerationWhat can be done?

• Social and community inclusion strategies
• The extent and quality of social networks,
  participation and relationships have
• Individual level health impacts
• Population level health impacts
• Policy options for reducing health inequalities
• Bolstering individual social and emotional
  support
• Promoting horizontal integration and interaction
• Promoting vertical social interactions and bonds

WHO Europe (2006) Levelling Up - Part 2
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Community PlanningWhat is the best approach to
delivering HI outcomes?
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Community planningWhat are the priorities?

• Responding to demographic change
• Economic growth, job opportunities
• Education, lifelong learning, employability/skills
  
• Environment transport, housing, neighbourhoods
• Social justice, inclusion, equity
• Community safety and security
• Health improvement

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A Better Community Life
CPP Vision
Responding to demographic change
CPP Strategic Objectives
CPP Actions Outcomes
National level outcomes
A Better Scotland
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A Better Community Life
CPP Vision
Responding to demographic change
CPP Strategic Objectives
Getting people into work
Education learning, skills
Health improvement
Environments
Community safety
ROA
ROA
ROA/JHIP
ROA
ROA
CPP Actions Outcomes
Workless hholds Unemployment, New
Deal Incapacity Disability
Literacy numeracy School absence Foundation
skills
Smoking, Alcohol Diet, PA, etc
Access to services
Fear of crime Crime rates
National level outcomes
Wealthier
Smarter
Healthier Inequalities in Mortality
Sustainable
Safer
A Better Scotland
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A Better Life
CPP Vision
Responding to demographic change
CPP Strategic Objectives
National level priority outcomes
Health determinants
Reducing health inequalities
A Better Scotland